Objective To investigate the influencing factors of esophagitis in Feicheng City, a high incidence area of esophageal squamous cell cancer (ESCC) of Shandong Province, China. Methods In a high incidence community of ESCC, a cohort of residents aged from 40 to 69 were examined for esophageal lesions. The case group included 357 cases of esophagitis diagnosed by staining endoscope and pathogenic examination, and 500 persons with normal esophageal mucosa determined by gastric endoscope served as the control group. The associations of family history of esophageal cancer, smoking, drinking and nutrition ingredients with esophagitis were analyzed, and OR and 95%CI were used as the association indicators. Results Gender and age were regarded as adjusting factors. When no family history of esophageal cancer was used as the base line, the OR was 1.830 (95%CI:1.1832.833) for those whose first-graderelatives had suffered from esophageal cancer; when smoking index=0 was used as the base line, the OR was 1.852 (95%CI :1.1423.005) for smoking index≥500; when drinking index=0 was used as the base line,the OR was 1.789(95%CI :1.1412.804) and 1.642(95%CI:1.0292.621)for drinking index <130 and ≥130 respectively; when no-smoking and no-drinking was used as the base line, the OR was 1.889(95%CI :1.1433.122) for both smoking and drinking; the annual intake of nutrition ingredients was classified into three levels, and when the lowest level was used as the base line, the ORs for fat, folic acid and iron reached significant levels. Conclusion Family history of esophageal cancer, smoking and drinking are risk factors, but nutrition ingredients do not play obvious role for esophagitis. Abstinence from smoking and drinking is important to prevent esophagitis, and then reduce esophageal dysplasia and cancer in high incidence areas of esophageal cancer especially in those who have family history of esophageal cancer.