The incidence of another cancer in subjects with esophageal cancer is high. Gastric cancer is the most common. We report surgical treatment for esophageal cancer in four patients who underwent gastrectomy for gastric cancer earlier. Extended lymphadenectomy of the neck, mediastinum, and abdomen was performed together with subtotal esophagectomy for three patients with thoracic esophageal cancer. In the two patients who had undergone subtotal gastrectomy and Billroth II reconstruction, the esophagus was reconstructed with part of the colon from the left side, perifused by the left colic artery. In a third patient, who had undergone total gastrectomy and jejunal interposition, reconstruction was done with part of the colon from the right side. In the remaining patient, who had cervical esophageal cancer and who had undergone total gastrectomy, cervical esophagectomy and total laryngectomy were done, followed by free jejunal interposition. One patient with thoracic esophageal cancer died of pulmonary metastasis of the esophageal cancer 24 months after surgery. The three other patients were not found to have recurrence in the most recent follow-up. Esophagectomy and reconstruction are more risky and complicated in patients who have already undergone gastrectomy for malignancy. However, in patients who have undergone curative surgery for gastric cancer, curative treatment for esophageal cancer such as esophagectomy together with extended lymphadenectomy is indicated.