Since cases of spontaneous rupture of the esophagus are extremely rare and early symptoms of the disease are similar to those of emergency diseases of the chest and abdomen, the diagnosis and treatments are often delayed, resulting in an unfavorable outcome in some cases. A 49-year-old man had suffered from severe chest pain and postemetic hematemesis after consuming some alcohol. Because the patient was diagnosed as having a spontaneous rupture of the esophagus, the patient was referred to our hospital and underwent surgery 25 hours after the onset. There was a 3-cm vertical perforation in the left wall of the lower esophagus. The ruptured esophageal wall was directly closed by the layer to layer method and reinforced with fundic patch by Thal-Hatafuku. The post-operative course was uneventful and the patient was discharged on the 46th day after operation. This surgical procedure was very useful in the patient. We reviewed 59 cases, including our case, which occurred recently in Japan.