Objective To evaluate the application effects and complications of different anastomosis sites in thoracoscopic and laparoscopic esophagectomy. Methods Totally 336 Patients with thoracoscopic and laparoscopic esophagectomy form March 2012 to April 2017 were retrospectively included. According to the anastomosis sites of the tubular stomach, they were divided into 3 the anterior wall group, the posterior wall group and the (the greater curvature side of stomach). Incidence of anastomotic fistula, anastomotic stenosis and short-term complications were concluded and the effects of different anastomosis sites on the complications of esophageal cancer were analyzed. Results There were no statistically significant differences (P > 0.05) in the three groups at aspects of stricture of anastomotic stoma and reflux esophagitis. But the incidences of anastomotic fistula, residual or thoracic fistula, and infection rate were significantly lower in lateral wall groupthan two other groups (P < 0.05). There were 5 dead cases in anterior wall group (4.24%), 4 dead cases in back wall group (3.77%) and 1 dead case in lateral wall group (0.89%), differences were statistically significant among the 3 groups (P < 0.05). Conclusion Anastomosis in lateral wall can significantly reduce the incidence rate of anastomotic complications (especially for anastomotic fistula, residual or thoracic fistula), which guarantees the security of the anastomosisand has great application value.