Esophageal squamous cell carcinoma (ESCC) is the most common histological subtype of esophageal cancer, accounting for 85% of cases worldwide. Traditional treatments include chemotherapy, radiotherapy, and surgery, but the overall prognosis remains poor. Recent advancements in cancer immunotherapy, particularly immune checkpoint blockade (ICB) therapy using anti-PD-1/PD-L1 antibodies, have significantly improved clinical outcomes. ICB therapy has been rapidly integrated into standard first-line treatment regimens for ESCC. However, preoperative immunotherapy is still under investigation. This review summarizes the commonly used ICB antibodies in clinical immunotherapy for ESCC and discusses the advancements in combining immunotherapy with chemotherapy and radiotherapy in the perioperative treatment of ESCC. The combination of immunotherapy and chemotherapy offers a promising perioperative option for resectable ESCC, with neoadjuvant immunotherapy combined with chemotherapy showing encouraging major pathologic response rates without introducing new adverse reactions. Recent studies have demonstrated the efficacy and safety of immunotherapy combined with chemotherapy in the neoadjuvant setting, achieving high pathological complete response (pCR) and major pathological response (MPR) rates. Adjuvant therapy, which aims to eliminate subclinical metastatic lesions and reduce recurrence and metastasis, has also shown promising results with adjuvant nivolumab prolonging disease-free survival. Despite these advancements, challenges remain, including identifying predictive biomarkers, overcoming primary and acquired resistance, and maintaining durable efficacy. Future research should focus on these areas to further improve clinical outcomes and develop precise strategies for ESCC management.Esophageal squamous cell carcinoma (ESCC) is the most common histological subtype of esophageal cancer, accounting for 85% of cases worldwide. Traditional treatments include chemotherapy, radiotherapy, and surgery, but the overall prognosis remains poor. Recent advancements in cancer immunotherapy, particularly immune checkpoint blockade (ICB) therapy using anti-PD-1/PD-L1 antibodies, have significantly improved clinical outcomes. ICB therapy has been rapidly integrated into standard first-line treatment regimens for ESCC. However, preoperative immunotherapy is still under investigation. This review summarizes the commonly used ICB antibodies in clinical immunotherapy for ESCC and discusses the advancements in combining immunotherapy with chemotherapy and radiotherapy in the perioperative treatment of ESCC. The combination of immunotherapy and chemotherapy offers a promising perioperative option for resectable ESCC, with neoadjuvant immunotherapy combined with chemotherapy showing encouraging major pathologic response rates without introducing new adverse reactions. Recent studies have demonstrated the efficacy and safety of immunotherapy combined with chemotherapy in the neoadjuvant setting, achieving high pathological complete response (pCR) and major pathological response (MPR) rates. Adjuvant therapy, which aims to eliminate subclinical metastatic lesions and reduce recurrence and metastasis, has also shown promising results with adjuvant nivolumab prolonging disease-free survival. Despite these advancements, challenges remain, including identifying predictive biomarkers, overcoming primary and acquired resistance, and maintaining durable efficacy. Future research should focus on these areas to further improve clinical outcomes and develop precise strategies for ESCC management.