Perforation of the esophagus is a rare complication of endotracheal intubation and usually occurs after hasty intubation. A 26-year-old female was transferred from other hospital for further management of empyema of the right lung. During admission, the empyema was found due to esophageal perforation, which had developed during the endotracheal intubation after acute poisoning of carbon monooxide 5 dayes prior to the transfer. The em-pyema and the esophageal perforation were successfully managed by conservative measures including effective drainage.