A 1-month-old Miniature Shetland colt was presented to the Burg Müggenhausen Equine Clinic. Primary complaints were regurgitation of milk, bilateral white nasal discharge, and weakness. Physical examination, endoscopy of the esophagus, and contrast radiography led to the diagnosis of an esophageal stricture and aspiration pneumonia. Surgical treatment by means of an esophagomyotomy was performed. The foal improved only temporarily and multiple sessions of endoscopic balloon dilation of the esophagus were performed afterwards. 12 months after the final treatment the foal was healthy and had no complaints regarding esophageal function.