An esophago-bronchial fistula developed on the 11th post-operative day in a 55-year-old man, who had undergone esophagogastric resection for adenocarcinoma of the cardia. He was immediately treated by primary repair of the fistula and interposition of an intercostal muscle flap. The post-operative course was uneventful and the patient is in good health at a 15-month follow-up. Esophago-respiratory fistula with no evidence of empyema can be successfully treated by primary repair. Immediate operation plays a key-role.