Objective To evaluate the effect of nasopharyngeal airway on airway management in patients undergoing radical surgery of esophageal cancer during anesthesia recovery. Methods A total of 96 patients undergoing radical surgery of esophageal cancer under general anesthesia were randomized into an intervention group and a control group, with 48 cases in each group.The control group was transferred to the PACU and given 3 L/min oxygen through a face mask, while in the intervention group, the nasopharyngeal airway was placed through the nasal cavity after anesthesia induction, through which oxygen was inhaled 3L/min in PACU after surgery.The SpO2 were recorded at the following 5 time points:entering the operating room (T0), entering the PACU (T1), removing the endotracheal tube (T2), 10 minutes after removing the endotracheal tube (T3), 30 minutes after removing the endotracheal tube (T4), and leaving the PACU (T5). The arterial blood gas analysis results at T0, T3, and T5 were recorded, and the complications such as agitation,nausea, vomiting, and laryngeal spasm were recorded during PACU stay. Results The intervention effect, time effect, time×intervention interaction effect in SpO2, PaO2 and PaCO2 were significant between the two groups (all P<0.05). The SpO2 at T3, T4, and T5 in the intervention group were significantly higher than those in the control group, its PaO2 at T3 and T5 were obviously higher than those in the control group, and its PaCO2 were significantly lower than those in the control group at the two time points (all P<0.05). Conclusion The preplaced nasopharyngeal airway in patients undergoing radical surgery of esophageal cancer can effectively reduce the incidence of hypoxemia during anesthesia recovery, and improve the ventilation of the upper respiratory tract.