The records of 780 patients who had 917 sessions of rigid oesophagoscopy and instrumentation for advanced cancer of the oesophagus were reviewed. Forty-three cases of iatrogenic perforation of the oesophagus were identified. Of 19 patients who were treated with immediate Celestine tube introduction, 13 survived. Only 2 of 9 patients treated conservatively survived. Routine oesophagography after rigid instrumentation of the oesophagus should probably be added to our protocol.