While esophageal injuries are relatively rare, they can be devastating if missed. Join Dr Fitz as she discusses various pathologies involving esophageal trauma, including the larger tears of Boerhaave syndrome to the mucosal lacerations of Mallory-Weiss. In the emergency department, prompt diagnosis and management can mean the difference between a full recovery and rapid decompensation, so knowledge on this low occurrence high acuity disease process is key.