Introduction: Endoscopic removal of clots in complex huge esophageal hematoma is clinically rare. Case Presentation: A 48-year-old male patient presented to our hospital with vomiting blood with black stool for 1 day after drinking alcohol. Esophageal hematoma was diagnosed after chest CT and EGD. After conservative treatment with intravenous fluids, the patient's symptoms of vomiting blood persisted and the hemoglobin dropped significantly. We decided to perform another EGD: the huge hematoma had ruptured. We performed endoscopic hemostasis and blood clot removal. Long-term postoperative follow-up shows good mucosal healing. Conclusion: Endoscopic clot removal is an effective method of treating esophageal huge hematoma complicated by rupture.