The provision of enteral nutrition through a nasogastric tube is a routine procedure in the intensive care unit (ICU), but it can lead to complications from intestinal intolerance, such as aspiration. This case report highlights a rare esophageal bezoar complication in a 43-year-old male paraplegic patient with multiple traumas who developed high paraplegia and lost spontaneous respiration, requiring invasive ventilation and nasogastric tube enteral nutrition. Despite 28 days of nutritional support, the patient experienced regurgitation and esophageal obstruction, which was confirmed on CT and endoscopy to be an esophageal bezoar, leading to worsened energy deficiency and clinical exacerbation. Conclusion: This case illustrates the rare occurrence of an esophageal bezoar formation in a patient with high-level spinal cord injury, resulting in compromised respiratory and gastrointestinal functions. Esophageal bezoars can cause regurgitation and may worsen prognosis.