Physicians frequently use transesophageal echocardiography (TEE) for clinical cardiology and during surgery. It is considered a safe procedure, and only a few cases of complications have been reported in the literature. We present the case of a 78-year-old man who experienced a perforation of the hypopharynx following TEE. The perforation went unrecognized for 10 days. Computed tomography identified a cervical abscess, which was drained. The patient recovered and was doing well at the 1-year follow-up. Hypopharyngeal perforation is a rare but potentially life-threatening complication. Surgeons should know and recognize its clinical signs to prevent its occurrence.