[ABSTRACT]OBJECTIVETo investigate the diagnosis, treatment method, key points of operation, and postoperative complications of high-risk esophageal foreign body.METHODSA retrospective analysis of 41 cases of high-risk esophageal foreign body from January 1996 to December 2014. After adequate preparation, the foreign body was removed via esophageal endoscope under general anesthesia.RESULTSThe foreign bodies in 41 patients were removed via esophageal endoscope once or twice. Two cases suffered postoperative subcutaneous emphysema, that may be a result of a small perforation in esophagus. Emphysema was disappeared by fast, rehydration and anti-infection for 6 to 8 days, and other serious complications did not occur.CONCLUSIONMost high-risk esophageal foreign bodies can be removed through rigid esophagoscopy. Some of the foreign bodies of the patients were difficult to remove, some patients were presented with mediastinal emphysema and pneumothorax due to esophageal perforation, and some foreign body stuck in oesophagus so long to cause esophageal mucosa ulcer. In these conditions, foreign bodies should be removed by lateral neck incision or thoracotomy.