Despite efforts to reduce exposure to corrosive household products there are still 5,000 new cases of severe caustic material ingestion injuries (CMI) in the United States each year. If managed inappropriately the associated morbidity and mortality are substantial. In this review we will try to highlight the clinical presentation, diagnostic and management of caustic material ingestion injuries. We will focused on the current trends in the evaluation and management of patients that become more conservative compared to previous decades.