Background: Esophageal cancer is projected to increase by 35% through 2025 in the U.S. We investigated whether the presence of metabolic syndrome components differed between these two cancers in a veteran population. History of gastroesophageal reflux disease (GERD) was also evaluated. Methods: Records of patients diagnosed with esophageal carcinoma between 1996-2014 were reviewed. Patients with incomplete documentation were excluded. Information on demographics, BMI before diagnosis, hypertension, hyperlipidemia, hyperglycemia, GERD, and diabetes mellitus (DM) type 2 was collected. Statistical analysis was performed using IBM SPSS Statistics 22.0 software and proper data-dependent statistical testing. Results: Of the 118 eligible patients, 81 were classified as having adenocarcinoma (EAC) and 37 as having squamous cell carcinoma (SCC). Age at diagnosis for EAC and SCC was 67.1±9.7 vs. 67.0± 10.8 years, (p = 0.83). Compared to SCC, patients with EAC were more likely to be white than African American (98.8% vs. 59.5%, p < 0.001). Veterans with EAC had a higher mean pre-diagnosis BMI than those with SCC (29.7±6.5 vs. 25.0±8.0 kg/m2, p < 0.001). Patients with EAC were more likely to have hyperlipidemia (59% vs. 35%, p = 0.015), GERD (51% vs. 22%, p = 0.003), hyperglycemia (44.4% vs. 27.0%, p = 0.07) and type 2 DM (37% vs. 19%, p = 0.049) than those with SCC. The two groups did not differ on HTN (59.3% vs. 56.8%, p = 0.80). Pre-diagnosis BMI (OR = 1.11; 95% CI = 1.01 to 1.21) and GERD (OR = 3.60; 95% CI = 1.27 to 10.19) were independent predictors of type of cancer – i.e., significant after controlling for the other variables. Hyperlipidemia (OR = 1.94 [0.63 to 5.92]) and Type 2 DM (OR = 1.08 [0.32 to 3.67]) were not independent predictors of type of esophageal cancer. Conclusions: We found that type of cancer (EAC or SCC) was associated with presence of certain components of metabolic syndrome (i.e., pre-diagnosis BMI, GERD, hyperlipidemia, and diabetes mellitus type 2) with the former two being independent predictors of EAC when compared to SCC. With the increasing incidence of obesity, GERD, and metabolic syndrome in the Western world, it is important to evaluate the relationship of common morbidities to esophageal carcinoma, which for EAC has also risen.