Objective To construct a perioperative supportive care protocol for older patients with esophageal cancer based on the 4Ms theory and evaluate its application effects. MethodsA total of 108 older patients with esophageal cancer scheduled for radical esophageal cancer surgery were divided into a control group (n=55) and an experimental group (n=53) based on their admission time. The control group received routine perioperative nursing care, while the experimental group received perioperative supportive care which was developed based on the 4Ms theory. ResultsThe experimental group showed significantly shorter indwell time of chest drainage system, reduced time to first flatus and bowel movement, and length of postoperative hospital stay compared with the control group (all P<0.05). The total score of quality of life before discharge in the experimental group was significantly higher than that in the control group (P<0.05). ConclusionImplementation of perioperative supportive care for elderly esophageal cancer patients based on the 4Ms theory can promote their recovery and early postoperative quality of life.