Objective: To study the efficacy and safety of PD-1 inhibitors in the clinical treatment of athletic patients with advanced esophageal cancer. Methods: The observation objects of this study were selected from athletic patients with advanced esophageal cancer who were treated in our hospital. The number of samples was 74 cases, and the treatment period was from August 2019 to August 2021. The medical records of the above athletic patients were retrospectively analyzed, and the athletic patients were grouped according to the treatment plan. The athletic patients in the control group were treated with docetaxel, fluorouracil and other drugs, while the athletic patients in the observation group were treated with programmed death molecule (PD-1) inhibitors during the course of chemotherapy. The survival time, clinical efficacy and the occurrence of adverse reactions were comparing the two groups, and the neutrophil count to lymphocyte count ratio (NLR), neutrophil count/ (white blood cell count - neutrophil count) (dNLR) levels and changes in quality of life were analyzed in both groups. Results: The objective efficiency rate and overall controlling rate of the observing group were above those of the controlling group, P < 0.05; the duration of progression-free survival and general survival of the observing group were prolonged than those of the controlling group, P < 0.05; among the therapy-related adverse reactions of the observing group, there was no significant discrepancy in the incidence of various symptoms for the two groups, P > 0.05; the occurrence of immune-related adverse reactions of the two groups was analyzed. There was no obvious discrepancy in the occurrence of skin mucosal reaction, endocrine damage, hematotoxicity, immune pneumonia, immune myocarditis, and nephritis in both groups, P < 0.05; NLR and dNLR after therapy in the observing group were below those in the controlling group, P < 0.05; the scores of each item of quality of living score in the observing group were clearly superior to those in the controlling group, P < 0.05. Conclusion: The clinical application of PD-1 inhibitor has considerable efficacy in the clinical treatment of advanced esophageal cancer athletic patients, and the safety of this regimen is high, which is valuable for being further promoted and applied.