Complications related to perforations of the upper aerodigestive system carry a 15% mortality. Nine cases of intraluminal injuries to the hypopharynx and cervical esophagus are reviewed. Seven were related to iatrogenic causes and two associated with foreign bodies. This study details the cause and location of the injuries, associated signs and symptoms, and the resultant morbidity. A protocol for the management of suspected perforations is outlined.