Non-malignant tracheoesophageal fistulas in adults often occur due to complications after intubation. We present an 80-year-old female patient who was con sulted because of fever and increased thicky secre tions that need frequent aspiration. An intracranial hemorrhage 3 months earlier led to her undergoing a tracheostomy and gastrostomy due to the resulting prolonged intubation and nutritional issues. Both bronchoscopy and endoscopy confirmed the pres ence of a tracheoesophageal fistula (TEF) detected on computed thorax tomography. In bronchoscopy, TEF, which was opened and closed by both over inflated cuff and esophageal contractions, was ob served. She was not a candidate for surgery, and her relatives declined an esophageal stent placement. We managed the case by sending a jejunostomy catheter through the gastrostomy tube and position ing at least 45 degrees to minimize the reflux.