Intramural esophageal dissection (IED) can be described as a laceration between the mucosa and submucosa of the esophagus. It usually caused by rapidly increased intraesophageal pressure We report a case of IED which occurred after performing an esophagogastroduodenoscopy (EDGS). A 38-year-old male was transferred to the emergency department from a local clinic with suspicion of tracheoesophageal fistula (T-E fistula). He complained epigastric are pain, nausea and vomiting from 5 days ago. So he had been performed EGDS to find cause of epigastric area pain in the local clinic. And a pus secreting hole was found during performing EGDS that suspected as T-E fistula. Initial vital signs were stable and he complained acutely aggravated epigastric are pain after EGDS but had no tenderness on his abdomen. We could found air shade in the mediastinum just next to the trachea. We performed Chest computerized tomography (CT) and esophagography in order to evaluate T-E fistula or injury of the esophagus. Chest CT and esophagography showed presentation of a true and false lumen within the esophagus. The diagnosis of Intramural esophageal dissection was made based on chest CT and esophagography. We consulted to the thoracic surgeon, and primary repair of esophageal mucosa was done. Patient was discharged on POD #11 without complication. Most common causes of IED are iatrogenic causes such as standard endoscopy and endoscopic intervention. It has high incidence in the elderly women and the people who have bleeding tendency. Emergency physicians should consider IED in the case of epigastric area pain that has occured after endoscopy.