Secondary esophageal carcinoma usually originates from a primary site in either the lung or breast and produces obstruction and symptoms that frequently mimic a benign esophageal stricture or primary esophageal carcinoma. Esophagoscopy shows a smooth identation, usually covered with normal mucosa; the appearance resembles a benign esophageal stricture. Esophageal biopsy in patients with secondary tumors is often negative for carcinoma. The radiologist plays a significant diagnostic role by his ability to show that the cause of the stricture is extramucosal and may be due to a secondary carcinoma involving the esophagus.