Retrograde cricopharyngeal dysfunction (R-CPD) is a recently described disorder characterized by an inability to belch, excessive flatulence, unpleasant gurgling noises, and discomfort in the lower neck, chest, and abdomen. Herein, we describe a case of R-CPD in a 19-year-old man. The patient suffered from flatulence and was unable to belch since birth; auxiliary examination of his digestive system was normal. He was diagnosed with R-CPD based on clinical manifestations and laboratory results. He received an injection of botulinum toxin to the cricopharyngeal muscle under ultrasound, catheter balloon, and electromyographic guidance. His symptoms completely resolved 1 week after the injection.