Esophagus perforations are serious and clinical manifestations. The most common cause is iatrogenic. Other causes are spontaneous, foreign bodies, trauma, tumors and drinking corrosive reagents. Spontaneous perforations constitute 12-15% of esophagus perforations. The most common cause of spontaneous perforations is Boerhaave syndrome. Boerhaave syndrome is total layer rupture at cardioesophageal junction following increased abdominal pressure and gagging. Its classic presentations are vomiting, thoracic pain and subcutaneous emphysema. The important diagnosis method is suspicion. We have presented the patient who came to our emergency service with respiratory disorder following gagging and vomiting after drinking plenty of water for ultrasonography and was diagnosed as Boerhaave syndrome.