Objective To investigate the prevalence of cardiometabolic diseases (CMD) among elderly patients with esophageal cancer with a view to providing reference for their prevention and treatment. Methods The study enrolled 1591 elderly patients with esophageal cancer from January 2008 to March 2018. Analysis was made of the major CMD including diabetes, hypertension, ischemic heart disease and stroke. The prevalence of CMD, the number of concomitant CMD, and the risk factors of CMD in elderly patients with esophageal cancer were analyzed. SPSS statistics 23.0 was used for data analysis. Results Of the 1591 patients [average age(71.84±5.00) years; female 25.14%(400/1591)], 23.57%(375/1591) had at least one CMD, and 6.47%(103/1591) had two or more. The prevalence of CMD tended to increase with age without statistically significant difference. The prevalence was 6.60%(105/1591) for diabetes, 17.10%(272/1591) for hypertension, 5.34%(85/1591) for ischemic heart disease, and 1.76%(28/1591) for stroke. Increasing age, high body mass index, and non-farmer might be associated with the comorbidity of CMD and esophageal cancer. Conclusion More attention should be paid to elderly patients with esophageal cancer complicated with CMD. Strengthened multidisciplinary cooperation is recommendable, special attention being paid to the risk of CMD in elderly and overweight patients with esophageal cancer.