Purpose Early surgical management is crucial for caustic injuries of the oesophagus to achieve adequate source control and prevent further mediastinal and abdominal contamination. We discuss a rare case of corrosive necrosis of the oesophagus requiring emergency oesophagectomy with early reconstruction via colonic interposition achieving excellent patient outcomes. Methodology We describe a 51 year-old man who presented post suicide attempt by ingestion of 500ml of aluminium hydroxide causing severe oesophageal injuries. His pre-operative and post-operative course was extensively reviewed alongside his eventual oesophageal reconstruction. Results The patient underwent a emergency oesophagectomy and proximal gastrectomy with a de-functioning cervical oesophagostomy and venting gastrostomy. On-table gastroscopy showed necrotic mucosa of the oesophagus which necessitated urgent surgical resection. The patient recovered very well post-operatively and underwent a oesophageal reconstruction with colonic interposition after clearance by multidisciplinary teams including psychiatry, medicine, dietician and physiotherapists. Decision for operation was made for early reconstruction, only 3 months post initial oesophagectomy. The patient progressed very well post-reconstruction and returned to normal oral intake within 5 weeks. Conclusion Early oesophageal reconstruction to restore intestinal continuity can be considered in suitable patients with caustic injuries post index oesophagectomy. Although more studies are required for substantial analyses, excellent post-operative recovery, nutritional stability and improvements in psychological wellbeing have been identified with earlier reconstruction.