An impacted esophageal foreign body is most often an urgent, rather than a life-threatening, medical situation. Pharmacologic or mechanical methods can be used to relieve the impaction, depending on the patient, as well as the location and physical properties of the foreign body. Flexible fiberoptic esophagoscopy is the accepted standard of care for removal of an object that is not smooth, radiopaque, inert or recently impacted. Although controversial, balloon catheter extraction may be an acceptable alternative in selected cases of esophageal impaction. Intravenous glucagon is useful in relieving distal impaction.