Surgery is mandatory in severe caustic burns of the upper digestive tract, either as an emergency, or later because of secondary complications. Then, the patients who develop oesophageal stenosis require oesophagoplasty or oesophagopharyngoplasty. The first clinical survey must be performed in a surgery department with an intensive case unit. All patients undergo an oesophageal examination with a fiberoptic endoscope when admitted. Some of them need a fiberoptic bronchoscopy. The authors describe their experience over the 18 years up to now. Over 700 patients were admitted in the same department. The different surgical procedures are given, as well as guidelines for management.