Spontaneous ruture of the esophagus, Boerhaave' s syndrome, was first described by Herman Boer haave. Such rupture are rare and usually occur during vomiting, with incoordinate esophageal contrac tion. Its diagnosis is frequently made late, which leads to high motalilty. We have experienced one case of Boerhaave' s syndrome which was treated successfully by nonsurgical measures including closed thoracostomy, antibiotics, and hyperalimentation. The patient had no complication and dis charged with good condition. (Kor J Gastroenterol 1998;32:834 - 838)