Tracheobronchial foreign bodies can usually be extracted by skillful application of endoscopic techniques. The authors report on experience in the treatment of an infant in whom a plastic object was extracted by an open surgical approach. The authors discussed clinical presentation and treatment options in the treatment of this patient who had a plastic pencil top lodged in the lung. In highly selected cases, an open surgical procedure entails less risk than endoscopic extraction. Copyright (C) 1998 by W.B. Saunders Company.