A patient with no pre-existing history of gastrointestinal disease developed a benign stricture of the esophagus after taking KCl slow-release tablets (Slow-K) while in the recumbent position in a coronary care unit. Management by bougienage using Malloney and Eder-Puestow dilators was undertaken and although complications occurred, a reasonably satisfactory result was obtained. The literature on K-induced stricture of the esophagus is reviewed in order to underscore the importance and severity of this complication and to suggest that this medical problem may be entirely preventable.