A series of patients with esophageal injuries was reviewed to evaluate the role of conservative management of these injuries. Between 1962 and 1978, we treated 108 esophageal injuries. In 74 percent of the cases, the injury was probably iatrogenic. Foreign bodies were the most frequent cause of noniatrogenic esophageal injury. Sixty-eight patients underwent surgery, while the remaining 40 patients received conservative treatment. Of 11 deaths in the series, eight occurred among the surgically treated group. Methods of treatment are discussed, and illustrative cases presented.