Placement of endotracheal tube, even for extremely short periods, can result in injury to laryngeal and tracheal tissue. This may be clinically insignificant, but in rare cases, it could be life threatening and results in permanent disability. Especially, tracheoesophageal fistula (TEF) is a serious and challenging problem because it may contaminate the tracheobronchial tree and interfere with nutrition. This uncommon but lethal complication has been reported to be associated with certain risk factors in tracheally intubated patients, and better knowledge of these factors could reduce the incidence of post-intubation TEF. We report a case of 49-year old male patient who has acquired TEF caused by endotracheal intubation and positive pressure ventilation.