Objective To investigate the effects of intervention strategies based on self-efficacy theory on nutritional status and cancer-induced fatigue（CRF） after total thoracoscopic esophageal cancer. Methods A total of 119 patients with esophageal cancer admitted to the Second Affiliated Hospital of Nanchang University from January 2017 to December 2020 were selected by convenience sampling method. They were divided into an experimental group（n=59） and a control group（n=60） according to random number method. Patients in the control group received conventional nursing,while patients in the experiment group take the self-efficacy theory as the instruction intervention strategy. The self-efficacy,nutritional status and T₄ CRF of 2 groups of patients were compared in the hospital（T₀）,1 month after discharge（T₁）,3 months after discharge（T₂）,6 months after discharge （T₃）,and 1 year after discharge（T₄）. Results The self-efficacy score of the experimental group was higher than that of the control group at different time points after intervention,and the risk score of nutritional status was lower than that of the control group,with statistical significances（P<0.05）. At T₄,the CRF score of the experiment group （33.90±6.30） was significantly lower than that of control group（44.93±7.66）（P<0.001）. Conclusion Nursing intervention strategies based on self-efficacy theory can significantly increase the self-efficacy of patients after thoracoscopic esophageal cancer surgery,improve their nutritional status,and alleviate CRF.