latrogenic esophageal perforation can result from balloon dilatation in the treatment of esophageal stricture, although surgery was the main method of treatment for the esophageal rupture. Conservative management has been emphasized recently as an alternative treatment. During the last 4 years, we have experienced 5 cases of esophageal perforation complicated by balloon dilatation for the treatment of benign esophageal strictures(1ye stricture:2, esophagitis:1, Muriatic acid(27%) HCI stricture: 1, postoperation of TOF: 1). We think that such complications were mainly due to selection of the improper size of balloon and severe esophagea stricture, and the leakage of barium in the mediastinum became a localized barium granuloma on follow up esophagogram. But they were uneventful except localized barium granuloma in the mediastinum with conservative treatment only. Our experience suggests that gradual dilatation with the proper sized balloon, along with prudent patient selection, can prevent unwanted esophageal perforation. Conservative treatment may be sufficient in cases with localized barium collection by perforation in the mediastinum.