A 31-year-old man with a history of allergic rhinitis, asthma and eczema presented to the emergency department with sudden dysphagia and food impaction while eating steak. He reported intermittent dysphagia and gastroesophageal reflux over several months despite proton pump inhibitor therapy. We diagnosed "steakhouse syndrome," or esophageal food impaction. The gastroenterology team performed urgent esophagogastroduodenoscopy, which showed furrowing and concentric rings, consistent with eosinophilic esophagitis. They extracted the impacted food endoscopically (Figure 1B). Esophageal biopsy showed eosinophilic esophagitis. We prescribed pantoprazole 40mg twice daily and fluticasone propionate 440g twice daily (swallowed, not inhaled). He has since required periodic dilatation of strictures. Esophageal eosinophilia (= 15 eosinophils per high power field) and exclusion of other potential causes of tissue eosinophilia (proton pump inhibitor therapy, Crohn disease, malignant disease, autoimmunity, drug hypersensitivity and parasitic disease) and endoscopy help confirm eosinophilic esophagitis.