A six year-old boy was taken this out-patient clinic with the complaints of cough and dyspnea of moderate degree. A round opaque shadow was shown between first and second ribs at the midline by P-A view of chest X-ray and the similar silhouette deviated to the trachea was also found at the same level by lateral view. Hence we performed direct esophagoscopy serveral times but there could not be found the material and could only be seen a part surrounded by some granulation tissues on the anterior wall of the middle portion between first and second physiological strictures of the esophagus. According to the bronchoscopic finding there was seen a small metal tip slightly protruded in accordance with the posterior wall of the trachea. So the esophagus was exposed by adding an incision of about 5 centimeters to the anterior border of the left sternocleidomastoid muscle by external approach to the esophagus and then the foreign body was taken off with forceps following the identification superiorly with a probe. Subsequently, a feeding tube was introduced into the esophagus through the nasal route and the esophageal wall was then sutured. The interesting facts in this case were that the foreign body itself was taken place a part of the esophageal wall and that the tip of it perforated the posterior wall of the trachea, and there was no symptom of foreign body despite that of the esophagus, and only cough and dyspnea were complained as the result of foreign body symptoms in the air passage. The postoperative course was satisfactory.