We conducted this study to help emergency physicians to make initial responding strategy for adult patients who ingested foreign bodies. A retrospective review of 1009 adult patients who presented with a foreign body ingestion and at least one of related symptoms at the emergency department of Asan Medical Center between January 2000 and July 2008. The assumed incidence of esophageal foreign body and esophageal perforation in adult was 19.4% (196/1009) and 1.8% (18/1009), respectively. Chest pain was more commonly found in patients with complications. 44% (8/18) of patients were treated in the intensive care unit but there was no in-hospital mortality. The assumed incidence and the rate of serious complications caused by the esophageal foreign body was relatively higher than those reported in previous studies. Prognosis, however, was favorable with timely proper treatment.