A diabetic 73-year-old man had admitted and examined gastrofiberoscopy due to dyspagia and weight loss of 6 kg during two months. He was confirmed diagnosis of esophageal squamous cell carcinoma. During the esophagography, we found the dye spillage into pericardial space from the esophagus with air collection. A following chest roentgenogram revealed a typical pneumopericardium with pericardial air filling. Although intensive care was done, he expired 4 days later. We report a case of typical pnemopericardium caused secondary to esophageal cancer.