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The esophageal perforation is a well-documented clinical entity, with high morbidity and mortality rates. Although the etiology is usually iatrogenic, it can occur spontaneously without any known pre-existing esophageal patology. Boerhaave first described it in relation to the increased intra-abdominal pressure. Upon clinical suspicion (for the Mackler’s triad), further radiological studies (plain radiograph, chest radiograph with water-soluble contrast medium and computer tomography) are a key factors for a timely and precise diagnosis, leading to adequate treatment and managment. The objective of this study is to present a case report and a bibliographical review of the patology and its radiological signs.