Impaction of the fishbone over the throat is a common presenting complaint to emergency department. In an uncomplicated cases, removal can be done easily in emergency department or clinic setting using Keluskar fish bone forceps under direct visualization or endoscopic guidance. In some unfortunate cases, fishbone may migrate to other structures causing complications such as neck abscess, airway obstruction, major vessels injury, mediastinitis and even death. High suspicion based on history and clinical examinations are vital so that patient can be referred to Otolaryngologist early and prevent these complications. Patient with fish bone impaction may present with foreign body sensation, localized odynophagia, and dysphagia. Common impaction sites are the oral cavity, oropharynx/hypopharynx, and esophagus. However, in some cases, extraluminal migration of sharp foreign body is possible, leading to symptoms despite negative scope findings. Although a plain radiograph is cheap and easily done, it offers great value in diagnosing radiopaque foreign bodies.