With increasing incidence by years, esophageal carcinoma has now required next-generation of treatment approaches. Currently anti-angiogenesis treatment has drawn much research interest for malignant tumors. However, the single parameter of micro-vascular density may not fully reflect the formation of tumor vessels in esophagus cancer. Therefore more experimental approaches are required to detect morphological changes of micro-vessels and their angiogenesis. This study therefore investigated the prognosis of esophagus cancer by the combination of microvascular pattern, density and imaging. A total of 148 esophagus cancer patients were recruited for 64-row spiral CT before and after the surgery. Immunohistochemistry (IHC) method was employed to detect microvascular density (MVD) and expression of D34/CD105 monoclonal antibody in vascular endothelial cells. Correlation between CT perfusion parameter and MVD indexes with malignancy of tumors was analyzed. CD34 and CD105 expressions were marginally elevated in malignant tumor then benign tumor but without statistical significance (p>0.05). Perfusion indexes including BF, BV, and PS of malignant tumors were significantly higher than benign ones (p<0.05). MTT index, however, had no significant difference (p>0.05). Spearman analysis revealed positive correlation between BF, PS, BV, MTT and MVD. CT perfusion index can quantitatively analyze the perfusion status of tumor blood flow. MVD and CD105 can specifically target novel endothelial cells of tumors and have potency in both treatment and diagnosis of esophageal cancer.