The nasogastric tube syndrome (NG tube syndrome) is a rare but a potentially life-threatening complication of a patient with indwelling nasogastric tube feeding. The cause of the syndrome is due to the NG tube irritation, resulting in ulceration and infection of the posterior cricoid region with subsequent dysfunction of vocal cord abduction. This dysfunction may result in complete loss of vocal cord abduction and cause serious airway obstruction. Reports of this syndrome are rare in the literature. A 64-year-old female patient with long-term NG tube feeding, suffered from serious upper airway obstruction. The patient had obvious desaturation while the tracheostomy tube was corked, and the endoscopic findings showed severe upper airway swelling. The symptoms associated with NG tube syndrome improved gradually after the NG tube removal pollowing a percutaneous endoscopic gastrostomy (PEG). We present the clinical course of the case with NG tube syndrome and provide a comprehensive review of this topic.