Traumatic esophageal disorders comprise several groups of injuries including iatrogenic and noniatrogenic (i.e., spontaneous blunt or penetrating and chemical or caustic) trauma. Practical approaches to managing esophageal trauma are often dictated by the nature of the underlying injury and the experience and preference of the surgeon. Consequently, although many of the same principles and techniques may apply, to ensure a comprehensive presentation of the topic, we have adhered to the accepted classification, by providing three different chapters based on etiology from the perspective of three different surgeons. Chapter 40 covers general management principles of esophageal perforation. This topic is pertinent for surgeons because esophageal perforation usually is the result of iatrogenic injury caused by instrumentation (e.g., esophagoscopy, bougienage, and achalasia dilation). Esophageal perforation can be difficult to diagnose promptly. Delay in treatment results in a high mortality rate. There are striking differences in etiology, presentation, treatment, and results of cervical versus thoracic perforation of the esophagus. Most cervical perforations respond well to simple drainage. Although the treatment of thoracic esophageal perforations is individualized, most patients are candidates for primary repair whether they are treated early or late. Chapter 41 further explores the aspects of blunt and penetrating traumatic injuries of the esophagus. In addition, this chapter discusses some of the procedure-specific complications that occur and techniques for management. Chapter 42 completes the general discussion of traumatic esophageal injuries by reviewing the arena of caustic injuries. These chemical exposures cause injuries ranging in severity from first-, second-, or third-degree burns to full-thickness necrosis and frank perforation, often requiring surgical treatment. The authors discuss the acute management of the immediate injury and follow with a review of the surgical options for chronic management or surgical replacement therapy, including treatment of common chronic sequelae from these types of chemical injuries. Finally, Chapter 43 reviews the indications for and techniques of esophageal exclusion. Despite advances in surgical technique and critical care over the past decades, esophageal perforation remains a challenging clinical problem. Early diagnosis and prompt surgical treatment are the hallmarks of successful outcome after spontaneous (e.g., Boerhaave's syndrome) and iatrogenic esophageal perforation. The most challenging issues a surgeon faces when taking care of acutely injured patients with these types of injuries is determining the proper technique for early management and deciding when to implement the appropriate therapies or interventions. This last benign esophageal chapter helps to place this clinical conundrum into perspective.