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Objective: To analyze the epidemiological characteristics of incidence and mortality of esophageal cancer in Shandong Province from 2012 to 2023. Methods: Data on incidence and mortality of esophageal cancer from 2012 to 2023 were obtained from the Shandong Provincial Cancer Registry. Crude and age-standardized rates stratified by year, gender and urban-rural residence were calculated using the standardized population of China in 2000. Joinpoint Regression Program 4.8.0.1 was adopted to estimate the annual percent change (APC) and average annual percent change (AAPC). Results: Both crude and age-standardized incidence rates of esophageal cancer in Shandong Province declined remarkably from 2012 to 2023, with the AAPC of -4.59% (P<0.001) and of -7.67% (P<0.001), respectively. Males had higher crude and age-standardized incidence rates than females, and rural areas presented higher rates than urban areas. For males, the AAPCs of crude and age-standardized incidence rates were of -3.33% (P<0.001) and of -6.89% (P<0.001). For females, the values were of -6.29% (P<0.001) and of -10.73% (P<0.001). In urban areas, the AAPCs were of -4.59% (P=0.001) and of -6.68% (P<0.001), while those in rural areas were of -4.57% (P<0.001) and -8.16% (P<0.001). Crude and age-standardized mortality rates also showed a significant downward trend, with the AAPC of of -4.48% (P<0.001) and of -8.26% (P<0.001). Mortality rates were higher in males and rural populations. The AAPCs of crude and age-standardized mortality rates were of -3.70% (P<0.001) and of -5.53% (P=0.003) in males, and of -7.92% (P=0.001) and of -11.41% (P<0.001) in females. In rural areas, the corresponding AAPCs were of -4.64% (P<0.001) and of -8.49% (P<0.001). No obvious trend was observed in the urban crude mortality rate. The age-standardized mortality rate had no significant change from 2012 to 2014, and decreased significantly from 2014 to 2023 (APC= -7.68%, P<0.001). Age-specific incidence and mortality rose rapidly after 45 years and peaked in the 80-84 age group. Conclusion: The incidence and mortality of esophageal cancer have decreased significantly in Shandong Province in the past decade, with obvious gender and urban-rural disparities.