Tracheobronchial foreign body (TFB) aspiration is rare in adults, although incidence rates increase with advancing age. Risk factors for TFB aspiration in adults are a depressed mental status or impairment in the swallowing reflex. Symptoms associated with TFB aspiration may range from acute asphyxiation with or without complete airway obstruction, to cough, dyspnea, choking, or fever. In adults, many other medical conditions mimic breathing abnormalities similar to those associated with TFB aspiration. If the history is not suggestive, then only a high index of suspicion can ensure proper diagnosis and timely removal of the foreign body. Initial treatment is airway support. Radiographic imaging may assist in localizing the foreign body. Bronchoscopic removal of the foreign body is necessary to avoid long-term sequelae. Flexible bronchoscopy is effective both in the diagnosis and removal of foreign bodies.