Objective To investigate the correlation between end-to-side anastomotic angle and postoperative anastomotic stricture in the surgery of esophageal carcinoma. Methods From January 2011 to June 2015, 130 patients with middle/lower esophageal carcinoma or gastric cardia cancer underwent operations in Shanghai Pudong Hospital and Lishui Central Hospital, Zhejiang Province. Depending on the end-to-side anastomotic angle, they were randomly divided into two groups (n=65 in each): a 0 degree group (49 males and 16 females, aged 64.5±8.3 years) and a 45 degrees group (52 males, 13 females, aged 61.7±9.1 years). Stooler degree grading was adopted to evaluate the anastomotic stricture in each group 6 months postoperatively. Results There were two patients with anastomotic fistula in each group (P>0.05). Pathology showed squamous carcinoma in 116 patients and adenocarcinoma in 14 patients. The postoperative esophageal stricture in the 45 degrees group was significantly less than that in the 0 degree group. There was no statistical difference in the duration of chest tube (5.9±6.7 dvs. 5.8±6.8 d) and recovery of intestinal peristalsis (2.6±0.8 d vs.2.6±0.7 d) between the 45 degrees group and the 0 degree group. Conclusion Esophagogastric anastomotic angle is related to the formation of postoperative anastomotic stricture. Oblique anastomosis with 45 degrees is helpful to decrease the severity of stricture.