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Aim: The aim is to retrospectively evaluate the clinical outcomes and treatment related toxicities in patients of synchronous esophageal and head & neck cancer when treated with definitive radiotherapy with or without concurrent chemotherapy. Background: Patients of esophageal cancer with a synchronous second primary in head and neck region can be treated with definitive radiotherapy but the clinical outcome has been reported to be poor. Method and Design: This is a single institutional retrospective study. Twenty-five patients fulfilling inclusion and exclusion criteria were evaluated. The survival was analysed using Kaplan–Meir method and their relations with various clinicopathologic parameters were compared. Results: After a median follow-up time of 14 months, the 1 year and 2 year survival was 60% and 17% respectively. Significant improvement in overall survival was observed in patients with early staged esophageal cancer then locally advanced disease (P = 0.03). Patients with locally advanced head and neck cancer had poor survival than with early stage disease (P = 0.06). Those who received concurrent chemotherapy had better survival than those with radiotherapy alone. 40% patients developed grade III & IV dermatitis and 48% patients developed grade III oral mucositis. Conclusion: Chemoradiotherapy can safely be offered to patients with synchronous esophageal and head and neck cancer.