Objective To evaluate the prognostic value of ¹⁸F-fluorodeoxyglucose（FDG） positron emission tomography（PET）/computed tomography（CT） （¹⁸F-FDG PET/CT） metabolic parameters combined with clinical characteristics in treated patients with esophageal squamous cell carcinoma（ESCC）. Methods The clinical data of 75 patients （65 males and 10 females，age of 63.41±7.75 years） with pathologically confirmed ESCC in * Hospital from January 2015 to November 2021 were retrospectively analyzed. All patients underwent ¹⁸F-FDG PET/CT examination after treatment. The relevant parameters of ¹⁸F-FDG PET/CT were determined：whole body SUVmax（SUVmaxwb）； SUVmean and metabolic tumor volume（MTV） were measured with 40% SUVmax as the critical value，and whole body MTV（MTVwb） and whole body total lesion glycolysis（TLGwb） were calculated. Kaplan-Meier survival curves and Cox proportional hazards model were used to evaluate the relationship between PET parameters and overall survival（OS）. Results Fifty-two（69.3%） patients died. PET-positive patients exhibited a 6.029-fold increased risk of death compared with PET-negative patients（P<0.001），with the median survival time of 22.3 months and 43.2 months，respectively. PET-positive patients were categorized based on median parameters of PET：SUVmaxwb=11.09，MTVwb=27.07 cm³，and TLGwb=162.34 g. Kaplan-Meier survival curves and log-rank tests revealed the correlations of pathological classification，M stage，post-PET anti-tumor treatment，MTVwb，and TLGwb with OS. M stage emerged as an independent predictor for OS（hazard ratio=5.698，95%CI=1.791-18.123，P=0.003）. Patients positive for both PET imaging and serology had a 6.112-fold higher death risk compared with those negative for PET imaging（P<0.001）. Conclusion ¹⁸F-FDG PET/CT volume metabolism parameters are significant prognostic predictors for treated patients with ESCC，and patients positive for PET imaging and tumor markers are associated with a poor prognosis.