Esophageal burn injury remains a significant medical problem in children despite efforts to reduce exposure to caustic household products. Depending on the type of ingestion, the event may result in a medical emergency with the child requiring immediate intervention. Acids and alkalis produce different types of tissue injury. In general, alkaline substances tend to be more palatable than acidic products, which often results in the ingestion of larger quantities and a higher risk of serious injury. Airway symptoms are not common, but dyspnea is usually a sign of a substantial injury. Esophageal injury is graded at the time of endoscopy. Long-term treatment with proton pump inhibitor therapy may be needed in patients with extensive esophageal injury, due to impaired esophageal motility leading to slow clearance of acid reflux. Most patients develop esophageal dysmotility with delayed clearance of gastric refluxate following severe caustic burn injury. Specific complications can be anticipated based on battery orientation and location of esophageal injury.