A symptomatic megaesophagus was demonstrated in a three months old boy with Chagas disease. He had a difficult evolution with frequent aspiration pneumonias and progressive undernutrition. At 14 years old a cardiomyotomy (Heller's procedure) was performed, with good results that allowed a near normal life. At 27 years old. the patient started with progressive dysphagia due to an epidermoid esophageal carcinoma and died after surgery. Since a higher frequency of esophageal carcinoma is observed in achalasia, periodic endoscopic examinations are mandatory.