Forty-five previously untreated patients with advanced inoperable esophageal cancer were treated with telebrachytherapy to a dose of 20 Gy in five fractions during one week (4 Gy per fraction by anteroposterior fields). Two weeks later, high dose rate intraluminal brachytherapy was given to a dose of 10 Gy at 1 cm from the source axis. Following initial evaluation of 20 patients at the end of four months the dose was decreased to 15 Gy in five daily fractions. This analysis was done at the end of one year and includes 34 patients who received teletherapy of 20 Gy and 11 patients who received teletherapy of 15 Gy. The dysphagia-free survival rate was 34% (20 Gy, 37% and 15 Gy, 33%), and the overall survival rate was 31% for the entire group (20 Gy, 34% and 15 Gy, 28%). The complication-free survival rate was 55% for the group that received 20 Gy and 83% for the group that received 15 Gy of teletherapy (P>.05). There was no significant impact of age, sex, race, length, tumor grade, or dose of external beam radiotherapy an dysphagia- free, overall, and complication-free survival (P>.05). In advanced cases, telebrachytherapy can provide significant palliation in the management of esophageal cancer.