Removal of foreign bodies from the tracheobronchial tree is generally possible by bronchoscopy. Seldom requested is a thoracotomy, to be considered an "ultima ratio" for cases with asphyxia, with an acute or chronic obstructive pulmonary infection, for cases-finally-of very little foreign body in a peripheral location. We collected in the past fifteen patients who had a thoracotomy for a tracheobronchial foreign body: extensive description is given of our most recent case.