Background: Caustic ingestion represents a severe clinical emergency, leading to variable and often unpredictable outcomes. The severity depends on the nature of the corrosive agent, the amount ingested, and the timing of management. Summary: This review provides an updated overview of post-caustic esophagitis, integrating epidemiology, pathophysiology, clinical spectrum, diagnostic strategies, and management principles. Special emphasis is placed on complications such as strictures, fistulas, and long-term nutritional consequences. To illustrate practical aspects, we present two recent cases managed in our department, reflecting the contrasting patterns of acid and alkali injury. A brief reference to our previously published retrospective analysis of 188 patients referred to Clinical Emergency Hospital of Bucharest between January 2003–January 2004 complements this clinical perspective. Conclusions: Post-caustic esophagitis remains a major therapeutic challenge. Early endoscopic assessment, individualized management, and multidisciplinary follow-up are crucial to improving patient outcomes. Preventive strategies and public education are equally essential to reduce the incidence of this life-threatening condition.