Introduction:The nasogastric tube (NGT) is frequently used in oncology in patients with tumors of the oral cavity. Often mild in the adults, this technique can lead to a gastric perforation which is a rare emergency surgery and of poor prognosis. Case Report: We report an interesting case of an old lady, tracheotomized for recurrent oral tumor, and got a NGT at his admission. After five days, computed tomography (CT) scan requested for extension assessment, discovered a gastric perforation by nasogastric intubation in the absence of clinical signs on physical examination. On CT scan, we have found evidence of gastric perforation, sign of the falciform ligament, ligamentum teres sign, and pneumoperitoneum. Finally, the patient has undergone a surgical repair. Conclusion: Computed tomography scan allows rapid diagnosis of gastric perforation though it is silent by showing pneumoperitoneum. Clinicians should systematically detect the favoring factors before insertion of NGT and think of any patient