Introduction: Pediatric traumatic esophageal perforation has high morbidity and mortality rates. It is most commonly iatrogenic in nature with penetrating trauma account for only 0.5% of cases. Case report: We report a case of pediatric penetrating trauma to the neck zone two causing both through and through cervical esophageal injury and laceration of the posterior wall of the trachea. A 6-year-old boy suffering from penetrating neck trauma due to blast explosion presented to us with severe respiratory distress and drooling of saliva. Diagnostic workup revealed both tracheal and esophageal injury. Immediate primary repair was done for both organs. Postoperatively, he developed ARDS which treated conservatively with good outcome.