Purpose: Oesophageal perforations are rare events, associated with life threatening morbidity including mediastinitis. Perforations can be due to trauma, foreign bodies, iatrogenic or spontaneous. We present a retrospective case series and describe management in a tertiary paediatric hospital of non-iatrogenic oesophageal perforations. Methodology: Retrospective data was collected on patients presenting to the Otolaryngology department with non-iatrogenic oesophageal perforations at Starship Hospital from 1/12/2010-1/11/23. Results: 3 patients with oesophageal perforations were identified. Case 1: 1 month old presenting with fever, with x-ray confirming retropharyngeal air and pneumomediastinum. The patient underwent a laryngobronchoscopy and oesophagoscopy with no perforation found. They were managed conservatively with antibiotics and feeding recommenced immediately post operatively. Case 2: 3 year old presenting with neck pain and vomiting following suspected blunt trauma to the neck. A x-ray confirmed retropharyngeal air. The patient was managed with antibiotics and kept nil by mouth for 1 day. Case 3: 14 year old presenting with a one day history of gradual onset throat and chest pain. X-ray and computed tomography (CT) confirmed retropharyngeal air and pneumomediastinum. The patient was managed with antibiotics and a proton pump inhibitor and kept nil by mouth for 1 day. Conclusion: Spontaneous and blunt trauma-related paediatric oesophageal perforations are rare. In our case series diagnosis was made with imaging, including x-ray and CT. All patients were managed conservatively with observation in hospital and a combination of antibiotics and proton pump inhibitor medical therapy. No complications were recorded.