Objective To investigate the current burden, temporal trends, future projections, and risk factors of esophageal cancer among population aged 20-60 years globally, regionally, and nationally from 1990 to 2023, so as to provide evidence for the prevention and control of esophageal cancer. Methods Based on data from the 2023 Global Burden of Disease Study database, trends in esophageal cancer burden were analyzed using estimated annual percentage change and Joinpoint regression, the influencing factors were examined using age-period-cohort model and breakdown analysis method, and the future projections from 2024 to 2050 were predicted using Bayesian age-period-cohort model. Results From 1990 to 2023, the number of incident cases, the number of prevalent cases, the number of deaths, and disability-adjusted life years of esophageal cancer among population aged 20-60 years showed an increasing trend, while the age-standardized rates presented a decreasing trend; the disease burden was substantially higher in males; the incidence patterns varied across regions and countries; and the incidence significantly increased with age. According to the predictions, the age-standardized prevalence rate of esophageal cancer among population aged 20-60 years was expected to rise continuously from 2024 to 2050, while the other standardized rates were predicted to decrease first and then increase. Smoking, high alcohol consumption, a diet low in vegetables, and chewing tobacco were identified as the main risk factors of esophageal cancer, and the mortality related to these factors had significantly decreased over time, with the most obvious reductions observed for smoking and high alcohol consumption. Conclusion It is necessary to strengthen early screening and intervention of esophageal cancer in areas with a high burden. Primary prevention and health education should be enhanced in combination with risk factors to reduce the incidence risk of esophageal cancer.