Extrathoracic extraction of esophagus by transhiatal blunt finger dissection for gastric pull up has become the technique commonly employed for performing total laryngopharyngeal esophagectomy.This procedure has been previously reported to be associated with pneumothorax.We reported an incidence of pneumomediastinum as the first complication in this procedure. A 40 yr old ,50 kg, ASA 1 patient was scheduled for transhiatal esophagectomy.