Esophageal hematoma is a rare form of esophageal injury. It may occur spontaneously, or in asociation with di-rect esophageal damage or a bleding diathesis. Endoscopy and computed tomography are generaly necesary for the establishment of a diagnosis. In this report, we present a case of esophageal hematoma that was discovered via a bedside transthoracic echocardiography. The echocardiography was conducted to evaluate an unexplained shock in a critically ill-patient. After conservative treatment, complete resolution of the esophageal hematoma was documented by a 7-day short-term follow-knowledge, this is the first case report regarding transthoracic echocardiographic detection, diferential diagnosis, and follow-up for esophageal hematoma. (Korean Circ J 2007 ;37:666-670)