Perforation of the hypopharynx, esophagus, and stomach complicated the insertion of flexible tubes in 11 adults. Nasogastric suction tubes were responsible for 5 instances of gastric perforation. Palliative intubation of obstructive carcinomas of the distal esophagus resulted in delayed perforation of the esophagus and stomach in 2 cases. The use of a Linton tube for decompression of bleeding varices caused esophageal rupture in 1 patient whereas 2 others developed pharyngoesophageal perforation due to misplaced endotracheal tubes. The remaining 1 case demonstrated penetration of a chest tube into the esophageal lumen. The radiographic features and mechanisms of these iatrogenic injuries are described and the pertinent literature is reviewed.