Foreign Body (FB) aspiration incidence follows a bimodal distribution and is commonly seen in children under the age of 5 or adults with advanced age. The type of FB can be organic or non-organic and varies depending on age, region of the world, and socioeconomic status. In children, FB aspiration is often a consequence of development and exploration. Aspiration of FB in adults typically occurs when cough reflex is blunted due to altered sensorium (from drugs, medications, advanced age), trauma to the airway, poor swallowing, or anatomical variations in the GI tract (strictures, Zenker’s Diverticulum, etc. Symptoms can range from cough to asphyxiation depending on the acuity of the aspiration event. Initial management is focused on ensuring there is no airway compromise leading to respiratory failure. Bronchoscopy is the treatment of choice to retrieve the FB. This chapter will review the incidence of FB aspiration in children vs. adults and will focus on diagnosis and treatment including bronchoscopy, role of ECMO, and surgical intervention.