Rationale: Gastrointestinal symptoms are most commonly observed in patients with diabetic ketoacidosis (DKA), which usually resolves completely with therapy. However, gastrointestinal symptoms may persist after DKA is resolved. Patient concerns: A 22-year-old female was admitted to hospital for epigastric pain and persistent vomiting. The results of laboratory examination showed fungal esophagitis complicated by DKA. Diagnosis: The patient was diagnosed with DKA associated with ascariasis and fungal esophagitis Outcome: The patient was discharged after treatment Lessons: In this case, despite the correction of metabolic acidosis, persistent nausea, vomiting and dysphagia can be a sign of esophagitis in patients with type 1 diabetes. Therefore, physicians should be aware of fungal infections associated with type 1 diabetes.