Foreign body ingestion is a common occurrence in children and specific high-risk group of adults. Although most foreign body pass through the gastro-intestinal tract without difficulty, sharp, pointed and elongated are associated with high risk of perforation, vascular penetration and other complication. Esophageal perforation is a critical condition resulting in mortality in most of the cases. Prognosis and outcome depend on perforation size, the time taken to identify the cause and diagnosis, underlying comorbidities and health of a patient. Common etiological factors for perforation includes: medical instrumentation [most commonly endoscopy], trauma, ingestion of foreign substance etc. Herewith, a clinical presentation of 61-year-old gentleman had an esophageal perforation due to ingestion of fish bone was presented with the relevant supportive literature. Patient presented with chest pain, mild abdominal discomfort and fever. Initial evaluation was misinterpreting and later revealed with esophageal perforation impacted by fish bone with acute inflammatory changes. Boston scientific fully covered self-expanding metallic stent placed, and patient becomes hemodynamically stable and the clinical outcome was successful and got discharged on 8th hospital day.
