Choking episodes and foreign body aspiration can be life threatening or result in significant morbidity. Choking continues to be a direct cause of death among children, most commonly occurring between the ages of one and four years. Various strategies have been used to decrease choking risks and prevent adverse outcomes. These have included alterations in product design and public education campaigns. Although education has been partially successful, primary care physicians can play a critical role in increasing education efforts during each well child office visit through anticipatory guidance of choking risks. Management of a choking child often involves collaborative efforts from the primary care physician, emergency room physician, otolaryngologist, pulmonologist, and radiologist. The purpose of this brief review is to provide an overview of the epidemiology and pathophysiology of choking and foreign body aspiration in children and to highlight important aspects of prevention and patient education.