Two cases of neonatal spontaneous rupture of the esophagus are described, one of which is associated with a duodenal stenosis. Seventeen cases have been reported. They present clinically with non-specific signs of respiratory insufficiency and radiologically by a right-sided hydropneumothorax. Esophageal opacification shows a leak above the diaphragm. A sudden increase in esophageal pressure at birth is considered to be a major etiologic factor leading to rupture. The presence of a duodenal obstruction support this hypothesis.