Four cases of tracheoesophageal fistula evaluated by computed tomography are presented. In addition to demonstrating the site of fistula, computed tomography was helpful in suggesting etiology and detecting pulmonary and mediastinal complications. Due to its ease of performance in critically ill patients and its unequivocal display of anatomy, we believe computed tomography should be the recommended diagnostic modality for tracheoesophageal fistula. © 1986.