Radiotherapy is one of the main treatment methods of esophageal cancer. Due to high resolution of soft tissue, MRI can effectively make up for the deficiency of CT, and it has become one of the important supplementary reference methods for the diagnosis and treatment of esophageal cancer. The T2WI-TSE-BLADE sequence of MRI has the advantages of motion correction, phase correction, and image reconstruction. The aim of the study was to discuss the correlation between the length of esophageal cancer tumors measured on the T2WI-TSE-BLADE sequence of MRI and the surgical pathological specimens, and analyze the role of T2WI-TSE-BLADE sequence in determining the target area range in the radiotherapy of esophageal cancer. Retrospective analysis of patients with esophageal cancer admitted to our institution from January 2016 to June 2019, 36 patients were enrolled. Four radiotherapy physicians delineated the GTV of primary esophageal tumors on three radiographic images, excluding metastatic lymph nodes. One chief radiologist determined the upper and lower boundaries of the tumor based on three types of imaging, namely the tumor length. All the measured data were expressed as?x¡Às. The t-test was utilized to analyze the measurement data, and P < 0.05 was considered statistically significant. Correlation was analyzed by Pearson method. The consistency test was performed by T2WI-TSE-BLADE-Altman method, and curves were drawn. The GTV data drawn by different physicians were analyzed by ANOVA. The length of esophageal tumor measured on CT image was significantly longer than that of pathological specimen, and the difference was statistically significant (P < 0.05). The measured length of the MRI-T2WI-TSE-BLADE image was slightly longer than that of the pathological specimen, and the difference was not statistically significant (P >0. 05). The correlation coefficients between tumor length measured by CT, MRI-DWI and MRI-T2WI-TSE-BLADE and pathological specimen length were 0.467, 0.723 and 0.896, respectively. According to the analysis results of ANOVA, there was no statistically significant difference in GTV volume independently delineated by four groups of physicians based on CT, MRI-DWI, MRI-T2WI-TSE-BLADE sequences (P >0.05). According on the specific GTV data delineated by the four groups of physicians, the volume point diagram was drawn. It can be seen that the volume delineated on the basis of MRI image was smaller than that of CT image. Compared with CT images, T2WI-TSE-BLADE sequence and DWI sequence had more obvious convergence trend. The T2WI-TSE-BLADE sequence can help clinicians to more accurately determine the upper and lower bounds of esophageal tumors and reduce the differences in GTV delineation between different physicians. Meanwhile, it can more effectively improve the unity of the individual understanding of the target area.