Introduction: The morbidity of anterior cervical fusion surgery is low and one of the least frequent is an esophageal perforation, but this can bring severe complications such as sepsis, mediastinitis, or death. Optimal treatment is multidisciplinary, although it remains controversial; This consists of primary closure or closure by means of a muscle flap, accompanied by rest of the esophagus and a high protein diet.

Clinical Case: A 27-year-old female patient who, after a car accident, presented a cervical vertebromedullary trauma that required posterior cervical decompression surgery followed by stabilization via the anterior approach on 2 occasions. In the postoperative period, she presented erythema in the operative wound, subcutaneous emphysema, and cervical edema, for which she was re-admitted to the operating room being diagnosed with esophageal fistula. Treatment was performed by placing a muscle flap, antibiotics, esophageal bypass, and a high protein diet by nasogastric tube. The clinical and laboratory evolution was favorable, presenting closure of the esophageal fistula.

Conclusion: Esophageal fistula is a rare complication of anterior cervical surgery and this requires multidisciplinary management.