A case of congenital esophago-bronchial fistula with bronchiectasia in an adult is reported. A 49-year-old female was referred to our hospital because of abnormal esophagogram. The most significant diagnostic image was bronchogram, which showed cystic bronchiectasia in the upper segment of the left lower lobe and a fistula measured 2 cm in length and 7 mm in diameter between the bronchus and esophagus. A closure of the fistula with left lower lobectomy was performed through 5th intercostal thoracotomy. The below findings are compatible with congenital natures of the fistula. 1) The fistula was associated with few adhesion and was divided easily. 2) Histologically, the fistulous tract was lined with squamous epithelium with muscularia mucosa.