Objective To analyze the clinical diagnosis and treatment of pediatric tracheo-bronchial foreign body cases and therapeutic effects. Methods A retrospective review of the clinical manifestations, the feature of ima- geology and the methods of removing foreign body of 120 cases of pediatric tracheobronchial foreign body, which were confirmed with tracheobronchial foreign body by direct laryngoscope or rigid bronchoscope. Results History of aspiration was present in 90.8 % (109/120) of all cases, penetration syndrome was present in 100 % (120/120) of all cases. Among 39 cases with tracheal foreign body, there were 26 cases with audible flapping sound in trachea, the fre- quency was 66.7 %. With the X-ray chest fluoroscopy showing media-stinal swaying,59 cases were confirmed to be with foreign body by bronchoscope. The accurate rate of diagnosing traeheobronehial foreign body via CT was 86.2 % (25/29). All cases were confirmed and treated by direct laryngoscope and rigid bronchoscope. The foreign bodies of 119 cases were successfully removed. 1 patient was turned into the department of chest surgery. Conclusion History of aspiration, penetration syndrome, audible flapping sound in trachea, X-ray chest fluoroscopy showing mediastinal swaying are important evidence in diagnosing tracheobronchial foreign body. The accurate rate of diag- nosing tracheobronchial foreign body via chest CT is relatively high. Direct laryngoscope and bronchoscopy are con- firming methods in diagnosing tracheobronehial foreign body; it is effective methods to remove traehco-bronchial for- eign body by direct laryngoscope and rigid bronchoscope.