Published in the Green Journal, this review examined the available clinical data that supports the benefit of protons vs photon-based radiation in reducing postoperative complications, cardiac toxicity, and severe radiation induced immune suppression, in the settings of proton therapy with and without current chemotherapy, as well as reirradiation. This review pointed out that there is still a lack of high-level evidence to support proton therapy in the treatment of esophageal cancer and large randomized trials will be needed to prove the benefits.