Objective To investigate the status and influencing factors of return to work in patients after minimally invasive esophagectomy, and to provide evidence for formulating targeted nursing interventions and promoting patients′ social reintegration. Methods A total of 310 patients undergoing minimally invasive esophagectomy were enrolled in a cross-sectional survey by convenience sampling.The general information, symptom burden, psychological status and social support were collected.LASSO regression and logistic regression were used to analyze the influencing factors of postoperative return to work. Results The overall return-to-work rate was 37.10%.The rates at 1 to 5 years after surgery were 33.09%, 36.25%, 31.48%, 57.14% and 65.22%, respectively. Logistic regression analysis showed that monthly per capita household income ≤2 500 yuan, occupation as civil servants or public institution, state-owned enterprise staff and farmer, postoperative duration over 3 years, and high psychological resilience were facilitators for return to work.Advanced age, chronic disease history, eating disorders and cough symptoms were inhibiting factors （all P＜0.05）. Conclusion The return-to-work rate of patients after minimally invasive esophageal cancer surgery is low, which is comprehensively affected by physiological, psychological and socioeconomic factors.It is necessary to develop individualized rehabi-litation programs integrating symptom management, psychological support and vocational counseling, and establish an inclusive workplace support environment at the policy level to facilitate patients′ social reintegration.