This is a case of an acquired tracheoesophageal fistula induced by a large foreign body in a 5-yr-old child. The foreign body, a large plastic ear from a doll, was lodged in the esophagus and its presence remained unknown for weeks, until tracheoesophageal fistula actually developed. The foreign body was removed endoscopically; after the child was given intravenous nutrition and the infection was brought under control, the communication was divided and repaired.