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Background: One of the most lethal damages of the gastrointestinal tract is esophageal perforation. The prevalent causes of esophageal perforation are diagnosis interventions, trauma, and Boerhaave’s syndrome. Although esophageal perforation after vomiting is rare, but has a high mortality risk; therefore, early diagnosis and treatment is essential. Case Report: The patient was a 44-year-old man admitted to the emergency room due to severe chest pain with a history of vomiting after eating egg, 4 hours ago. Vomiting was not too severe and the pain was in the right chest. After the diagnosis of esophageal rupture, the patient underwent thoracotomy. Conclusion: As esophageal perforation is a real emergency, on-time diagnosis and treatment is vital.