Esophageal perforation is one of the most serious injuries of the digestive tract and requires early diagnosis and early treatment. The very particular anatomical configuration esophageal, with no serous, allows after perforation of the wall, bacteria, saliva and digestive enzymes to easily pass the mediastinum causing mediastinitis, abscess, sepsis and multiorgan failure eventually, sometimes causes death. Causes may include iatrogenic manipulation, spontaneous rupture, traumatic injury and ingestion of foreign bodies or caustic substances, with the incidence of esophageal perforation secondary to ingestion of foreign bodies between 2 -15%. The treatment of this disease has long been a subject of ongoing debate, which management protocols are mainly oriented in the severity of symptoms, the drilling site, the time between drilling and etiology. Although it has traditionally been considered an almost lethal complication, advances in intensive care, antibiotic therapy, imaging and total parenteral nutrition, have substantially reduced both the morbidity and mortality of this process. While in adults, the surgical treatment of perforation is usually the first option considered by several authors, in pediatric patients currently conservative measures are the preferred treatment option. We report the case of an infant with esophageal perforation by foreign body, treated conservatively with favorable evolution.