A latest review examined the existing of PBT for locally advanced esophageal cancer, including dosimetric comparative studies, early clinical outcome comparisons of PBT with photon-based techniques, recently concluded and ongoing clinical trials, challenges and toxicities, highlighting the reduction of treatment-related lymphopenia with PBT, and quality of life. Current clinical outcome supports that PBT leads to improved disease-related outcomes and reduction in treatment-related AEs. Newer results from ongoing clinical trials will dictate the future utility of PBT versus photon-based RT.