Introduction: Esophageal foreign bodies are important and serious cause of morbidity and mortality in both children and adults, usually as a result of serious complications, such as perforation, necrosis, mediastinitis, and fistulation. Therefore, rapid and accurate diagnosis with subsequent removal is very important. Clinical Case: We present and discuss the presentation, diagnosis and surgical management of a 6-year-old with a 2-year history of ingested coin locked in the oesophagus. Discussion: Diagnosis was established by upper gastrointestinal endoscopy, barium swallow and chest x-ray. The coin was removed by open surgery via oesophagotomy through right thoracotomy after failed retrieval via rigid oesophagoscopy. Conclusion: Surgical treatment in the form of esophagotomy via thoracotomy may be necessary in some cases of impacted foreign bodies in the esophagus where endoscopic removal is unsuccessful.