Abstract: A 62-year-old man presented with intermittent dysphagia, choking and upper airway obstruction. During endoscopic examination, a polyp emerged from the esophagus and was aspirated into the trachea, resulting in significant acute respiratory distress. He was intubated and subsequently taken to the operating room where the lesion was removed under general anesthesia. A 4.5-cm polyp covered by nonkeratinizing stratified squamous epithelium was seen. The underlying stroma contained loose connective tissue with scattered fibroblasts, mixed inflammatory infiltrate, and prominent vessels. A diagnosis of giant fibrovascular polyp of the esophagus was made. In this report, we discuss the pathophysiology, symptoms, differential diagnosis, and management of this rare but benign lesion.