Abstract: Objective : To explore the clinical characteristics，diagnosis, differential diagnosis and treatment of spontaneous esophageal rupture and improve the clinical diagnosis ability.Methods:The clinical data of 2 cases with spontaneous esophageal rupture were retrospectively analyzed and the literatures were reviewed. One case was surgical treatment within 24 hours, other ease was treated with lavaging, drainaging and anti-infection. Results:One case cured through repairing, other case worsened because of his family giving up treatment. Conclusions:Obtaining complete and accurate disease historyis the key to avoid misdiagnosis. The chest radiograph, chest puncture, esophageal angiography and distinctive chest drainage can help diagnosis.The early diagnosis and surgerical repair and unobstructed drainage is the key of treatment.