Foreign body ingestion is common in infants and young children and can cause numerous complications, mainly if ingested and left in place for prolonged periods. In recent years, particular dangers, specifically from ingested button batteries, have become increasingly recognized as a public health issue. Of particular note is the rapid onset of full thickness burns and oesophageal perforation which may occur within as little as 2 h following the ingestion of button batteries. The aim of this review is twofold: (1) to increase awareness of the need for rapid action from radiologists, emergency care physicians and paediatricians on identifying a button battery impacted within the oesophagus, and (2) to review the imaging appearances that can distinguish button batteries from other similar appearing foreign bodies, most notably coins.