A 70-year-old woman was admitted to our hospital because of a cervical esophageal perforation caused by a flexible fiberscope. After an esophageal fish-bone foreign body was removed by a flexible fiberscope, the patient's cheek, neck and anterior chest wall started swelling. Chest X-ray and computed tomography revealed mediastinal and subcutaneous emphysema. Dyspnea was not observed, oral intake was withheld, and antibiotics were administered. Surgery was not attempted, since no symptoms were observed within 72 hours after the injury. Four days after admission, a fluoroscopic X-ray examination of the neck, thorax and esophagus was performed. Oral intake was restarted on the fifth day, and the patient was discharged on the tenth day.