Esophageal perforation is uncommon, however, due to the lack of serosa, inflammation spread is rapid and common to neighboring structures, causing mortality and morbidity. Initial symptoms for esophageal perforation have not been clarified, but when the diagnosis and proper treatment is delayed, its clinical course is fatal. Prompt recognition and proper treatment of esophageal perforation or rupture is mandatory. We report a case of 21-year-old man patient with esophageal perforation after anterior fusion of the cervical spine. Diagnosis was made by clinical suspicion and confirmed by esophagography and esophagoscopy. The patient was successfully treated by primary closure with good clinical course.