Prompt recognition and proper treatment of esophageal perforation or rupture may ax~ert death or minimize complications. We have experienced sixteen patients of esophageal perforation at the department of thoracic and cardiovascular surgery, Hallym Medical college during the period fromJan. 1986 to Sep. 1993. The ratio between male and female patient was 13:3 and their age ranged from 23 years to 67 years old. The major cause of esophageal perforations was spontaneous rupture in 7 cases[45%], surgical trauma in 2 cases[12%], instrumental trauma in 2 cases[12%], and others in 5 cases[31%]. The common site of esophageal perforation was in the lower third portion of the esophagus[10 cases, 62%]. The most consistent symptom of esophageal perforation was chest pain in 11 cases, temperature elevation within a few hours was 9 cases.Contrast roentgenographic studies demonstrated the perforation in all but 2 of the 16 patients. The frequent complications of esophageal perforation were empyema in 7 cases[45 %] and mediastinitis in 2 cases[12%]. fourteen patients had suture closure and drainage with 2 deaths, and 2 patient received only drainage procedures. The mortality rate was 12%[2 cases] and cause of death was sepsis and aortic rupture.