Objective To investigate the related factors affecting the metastases to left gastric artery lymph nodes in patients of esophageal cancer, and evaluate the clinical significance of resection of left gastric artery. Methods One hundred and eighty-six patients with esophageal cancer undergone esophagectomy and esophagogastrostomy were involved in these case-control study. The left gastric artery, lymph nodes and fat tissue around it were removed in these patients. Patients were divided into 2 groups according to the occurrence of metastases to para left gastric artery lymph nodes. Chi-square test, rank sum test, t-test and the logistic regression were adopted to analyze the correlations between these related factors and the metastases to para left gastric artery lymph nodes. Results Thirty-three patients had para left gastric artery lymph nodes metastases （17. 74%）. Related factors that affect the metastases to para left gastric artery lymph nodes were showed by monovariate analysis as follows： TNM staging of tumor, the metastases to paraesophageal nodes, paracardial nodes and subcarinal nodes （P〈0.001, P=0.025, 0.047,0.038）. Multivariate analysis showed that location of tumor was the only independent factor that influences the metastases of para left gastric artery lymph nodes（P= 0. 002）. Skip metastasis was a distinct feature of esophageal cancer, with a frequency of 78.79%（26/33）. Conclusions This study suggests that the major correlative factor of para left gastric artery lymph node metastasis is location of tumor. Resection of left gastric artery as a routine procedure in radical operation of esophageal cancer should be considered.