We have experinced 20 cases of esophageal perforation from April, 1987 to August, 1993 at ourdivision of Thoracic and Cardiovascular Surgery, Korea University, Gu Ro Hospital. Here we investgates the causes of disease, symptoms and sign, locations, time lag from onset, treatment of perforation and the results.The ratio between male and female patients was 12: 8, and age ranged from 4 years to 70 years old.The cause of esophageal perforation were instrumental trauma 7 cases, stab wound 4 cases, foreign body 4 cases, spontaneous perforations 3 cases, and others 1 cases. The middle and lower portions of esophagus was frequently involved portion in our cases [11 cases of 20].The common complications after perforation were mediastinitis [6 cases] and empyema [2 cases].The method of treatment were as follows, primary repair of perforation, simple drainge techniques including simple cervical drainage and closed thoracostomy, diversion and two-staged operations during several months. There was no mortality in our cases.