Oesophageal cancer is the second most common cause of cancer death in China and is particularly prevalent in northern China. Genetic factors have been studied less than environmental factors in the aetiology of this disease. This study was conducted to evaluate familial aggregation of oesophageal cancer. All households in Yangcheng County were interviewed in 1979 to determine family history of oesophageal cancer. In 1989, vital status for all family members from three Yangcheng villages was determined and re-interviews were conducted among families who reported a positive family history of oesophageal cancer in 1979. Risk of oesophageal cancer was evaluated by comparing family and individual rates of oesophageal cancer during the 1979-1989 interval stratified by the number of family members with oesophageal cancer prior to 1979. More families with prior oesophageal cancer history reported new oesophageal cancer deaths during the follow-up period than families without prior history (19% versus 5%). Oesophageal cancer rates increased with increasing positivity of family history, and adjustment for other risk factors did not substantially alter this result. We conclude that these data provide evidence for familial aggregation of oesophageal cancer.