Management of foreign bodies of the gastrointestinal tract is not standardized among the various specialties and subspecialties of physicians who care for these patients. This article gives a true emergency department approach to the patient with an ingested or inserted gastrointestinal foreign body. Evaluation and management of the foreign body by location are presented. Controversial issues such as Foley catheter removal of esophageal foreign bodies, management of sharp objects in the stomach, and management of body packers and body stuffers are discussed. Examples of foreign bodies encountered by the typical emergency physician are demonstrated.