Prior to her death from cancer in 2010, Earl befriended author John Green, who credited her for the inspiration to complete his bestselling 2012 novel The Fault in Our Stars.

[1] In 2014, Earl's writings were compiled with her biography This Star Won't Go Out, which appeared on the New York Times bestseller list for young adult books.

[2][3] Earl has been cited as an influential activist, with her family and online followers continuing to hold charity and fundraising events in her memory.

The Earls, whom The Boston Globe characterizes as "self-described wanderers", moved between Saudi Arabia, Massachusetts, and France.

[1] John Green, saddened by Earl's death, dedicated a eulogy in vlog format titled, Rest in Awesome, Esther.

Following her death, Earl's parents, Wayne and Lori founded This Star Won't Go Out, a non-profit organization which helps families that have cancer-stricken children.

[26][27] Esther Earl inspired the character Hazel Grace Lancaster in Green's 2012 novel The Fault in Our Stars as well as its 2014 film adaptation.

Green dedicated the novel to Esther but also found inspiration through others, including his son and wife, as well as his experience as a children's hospital chaplain.