Clozapine-induced esophagitis has been rarely reported. We herein report a case of a 61-year-old woman with schizophrenia who developed hematemesis, fever, and tachycardia after the initiation of clozapine. An esophagogastroduodenoscopy showed esophageal mucosal ulcerations. Her gastrointestinal symptoms resolved with pantoprazole, allowing continuation of her clozapine treatment. We report here an unusual association of severe esophagitis with clozapine use.