Forty patients with functional or morphologic esophageal abnormalities following radiotherapy were identified. Abnormalities included abnormal motility with and without mucosal edema, stricture, ulceration and pseudodiverticulum, and fistula. Abnormal motility occurred 4 to 12 weeks following radiotherapy alone and as early as 1 week after therapy when concomitant chemotherapy had been given. Strictures developed 4 to 8 months following completion of radiotherapy. Ulceration, pseudodiverticulum, and fistula formation did not develop in a uniform time frame. Radiation-induced esophageal injury is more frequent when radiotherapy and chemotherapy are combined than it is with radiotherapy alone.