Abstract A retrospective survey of patients having truncal vagotomy for duodenal ulceration has been carried out. In this series 41 cases of oesophageal perforation occurred; 29 were recognized at the time of operation, 6 were diagnosed postoperatively, and in the remaining 6 the time of diagnosis was not specified. Two of the 29 patients in whom the oesophageal perforation was recognized at the time of operation died, as did 2 of the 6 cases diagnosed postoperatively. An increase of mortality and morbidity occurred in those diagnosed postoperatively. The importance of confirming oesophageal integrity at the conclusion of vagotomy is stressed.