During a two-year period, the clinical courses of 33 patients with foreign body ingestion beyond the gastroesophageal (GE) junction were reviewed. Mean age was 12.7 years with a male predominance (5:1). Twenty five patients ingested blunt foreign bodies and 8 patients ingested sharp foreign bodies. All of the patients who ingested blunt foreign bodies were managed expectantly, and spontaneous passage of the foreign bodies were noted after an average of 3.8 days. Three of the eight patients who ingested sharp foreign bodies were operated on to extract the foreign bodies: an open safety pin, and a nail and a sewing pin. The decision to operate on the latter two patients were made after repeat x-rays failed to show progression of the location of the foreign bodies. The remaining five patients had spontaneous passage of the ingested sharp foreign bodies. Ingested sharp foreign bodies can be initially managed expectantly with little morbidity and mortality but only in the absence of signs of bowel perforation either presenting initially or during the course of observation. (Author)