Abstract Background Three-field dissection is usually adapted for selected patients with esophageal carcinoma. Exact metastatic rate of cervical lymph nodes for thoracic esophageal carcinoma remains speculation. Methods Three-field dissection was performed for 96% of patients who underwent radical esophagectomy for thoracic esophageal carcinoma during 2001–2010. Exact metastatic rate and survival after dissection of metastatic nodes were evaluated for assessment of efficacy of three-field dissection. Results During 2001 to 2010, 1075 patients underwent esophagectomy for thoracic esophageal carcinoma. Excluding 115 patients underwent salvage esophagectomy and 39 patients underwent R1–2 resection, 921 patients underwent radical esophagectomy. Three-field dissection was performed in 882 patients (96%) and avoided in 19 patients because of systemic morbidity. The incidence of clinically positive supraclavicular lymph nodes 6.7%. The incidence of pathologically positive supraclavicular lymph nodes 14.1%. According to tumor location, the incidence of pathologically positive supraclavicular lymph nodes was 18.3% for the upper thoracic tumor, 17.2% for the mid thoracic tumor, 8.4% for the lower thoracic tumor. According to cT category, the incidence of pathologically positive supraclavicular lymph nodes was 8.4% for cT1b tumor, 9.9% for cT2 tumor, 17.2% for cT3 tumor. Of 823 patients with clinically negative supraclavicular node, 82 patients (10%) had pathologically positive supraclavicular nodes. Of patients with clinically positive recurrent laryngeal nerve node, 27.1% of patiets had pathologically positive supraclavicular nodes. Over-all 5-year survival of patients with pathologically positive supraclavicular lymph node was 20.8% for the upper thoracic tumor, 31.5% for the mid thoracic tumor, 14.3% for the lower thoracic tumor. Conclusion Exact metastatic rate and survival after dissection of metastatic nodes for supraclavicular lymph node were evaluated for assessment of efficacy of three-field dissection for thoracic esophageal carcinoma. Of patients with clinically negative node, 10% of patients had pathologically positive supraclavicular nodes. High incidence of positive supraclavicular nodes in patients with clinically positive recurrent laryngeal nerve node indicated posibility of selection for three-field dissection. Overall 5-year survival of patients with pathologically positive supraclavicular lymph node was better than that of patients with organ metastasis reported previously. Disclosure All authors have declared no conflicts of interest.