Abstract Background Treatment of Esophageal Cancer (EC) consists of neoadjuvant radiochemotherapy (RCT) followed by resection. However, esophagectomy is associated with considerable morbidity in patients already burdened with comorbidities, malnutrition, and unhealthy lifestyle. In this context, a watch and wait (WW) strategy has gained importance in patients with complete response to RCT and has been adopted by our center a decade ago. Aims To investigate independent predictors for recurrence in patients with EC undergoing WW. Methods We retrospectively analyzed data of all patients with potentially curable EC and complete response to RCT from 01/2014–12/2020 at a tertiary university hospital. Patients underwent staging (computed tomography (CT), upper endoscopy with ultrasound and biopsies (EUS), and positron-emission tomography (PET)), followed by RCT with restaging six weeks after completion. Routine follow-up consisted of EUS every three and CT every six months. Clinical data were extracted from electronic medical records. Factors associated with recurrence were adjusted for patient- and tumor-characteristics in multivariate regression analysis. Results A total of 40 patients were included. Of these, 22 (55%) had cancer recurrence. Tumor type was squamous cell carcinoma in 24 (60%) and adenocarcinoma in 16 (40%), respectively. T3-stage was most frequent (n=26, 65%), 35 (88%) patients were nodal-positive. Mean age was 67 years (SD 8.8), 30 (75%) patients were male. Recurrence occurred after a mean of 413 days (SD 171). Multivariate analysis revealed a circumferential tumor extent >50% in staging (OR 15.229, p=0.017) and dysphagia at restaging (OR 6.336, p=0.023) as independent risk factors for recurrence. Conclusions The current study revealed tumor extent and dysphagia as independent risk factors for recurrence. These predictors may help in the early identification of patients with EC recurrence, thus contributing to a personalized follow-up.