SummaryObjective: The aim of the present study was to explore the association of the functional single-nucleotide polymorphism (SNP) rs3746804 in C20orf54 with the susceptibility to esophageal squamous cell carcinoma (ESCC). Methods: SNP rs3746804 in C20orf54 was detected by direct sequencing in 434 ESCC patients and 554 healthy controls from Shanxi and Henan Provinces in China, geographically a high incidence area for ESCC. The frequencies and distribution of TT, CT, and CC genotypes of SNP rs3746804 between those 2 cohorts were compared and its association with ESCC was assessed. Results: For SNP rs3746804 the genotype distribution of CT and CC in ESCC patients both significantly differed from those in healthy controls (p = 0.002, 0.001, respectively), while the distribution of TT did not differ significantly between the groups (p = 0.757). The ratio of T:C was high in healthy individuals and low in ESCC patients. Compared to genotype CC, both genotypes CT (odds ratio (OR) = 0.63, 95% confidence interval (CI) 0.48l-0.826), and CT+TT (OR = 0.654, 95% CI 0.507-0.844) were associated with significantly decreased risk for ESCC. Conclusion: A close association exists between functional SNP rs3746804 in C20orf54 and susceptibility to ESCC.