Pneumatic rupture is a rare cause of esophageal injury, as evidenced by only 19 cases reported in the literature. We experienced one case of esophageal rupture due to bursting of a truck inner tube. The patient, who was a 45-year old male, had severe chest pain, respiratory distress, flushing in the face and neck, and subcutaneous emphysema after tire explosion. Three days after the incident, a diagnosis of rupture of the thoracic esophagus was established by esophagogram using water soluble contrast media, and then emergency operation was done. The operation involved mediastinal and thoracic drainage and resection of the esophagus combined with cervical esophagostomy and feeding gastrostomy. On the 105th day after the operation, cervical esophagogastrostomy via substernal route was performed. The patient was successfully treated with the staged operations. As in the other reported cases, the injury was located in the lower one third of the esophagus. Four main characteristics of the clinical signs of pneumatic rupture are 1] wounds or burns to the face or mouth, 2] chest pain or epigastric pain, 3] subcutaneous emphysema, and 4] respiratory distress. We emphasize that the high index of suspicion of esophageal rupture is very important in diagnosis and that diagnosis should be based on the same findings common to other forms of esophageal injury.