The neck with cartilaginous framework left intact still requires a high index of suspicion of a pharyngoesophageal perforation after blunt trauma. If the diagnosis is missed and/or prompt surgical drainage of the perforation is delayed, increased morbidity from deep neck abscesses and/or death may result. This is the first reported series of pharyngoesophageal perforations that follow blunt trauma. On the basis of this clinical experience and the literature, I have formulated a treatment protocol for upper aerodigestive tract perforations secondary to blunt trauma.