Gastrointestinal involvement has been reported to occur in about 10 to 20% of patients with malignant lymphoma. The most common gastrointestinal site for the lymphoma is the stomach, followed by the small intestine, the ileocecal region and the colon. The esophagus is the least commonly involved gastrointestinal organ, accounting for less than 1% of patients with malignant lymphoma. We describe a case of primary esophageal and small bowel lymphoma presenting with bilateral main bronchial obstruction. The patient was treated with radiation therapy, small bowel segmental resection and combination chemotherapy. We report a case with a review of the relevant literature. (Korean J Gastrointest Endosc 2003;27:1014)