To explore proper operative methods for removal of irregular shaped foreign bodies in children. Forty-eight emergency cases of irregular shaped airway foreign bodies (plastic ball-pen cap, mini-toys, whistle, pin, thumbtack, milk tooth, pen, steel ball, stone of apricot, chicken bone and screw nail) from Jan. 1998 to Nov. 2000 have been reviewed, especially the operative procedure for removing foreign bodies. The youngest patient was 9-month old and eldest 14 year-old. The average age was 8.3 year-old. The male female ratio was 2.4 storz tracheoscope (Made in German) was applied. Forty-six of the 48 foreign bodies were removed through tracheoscope. The foreign bodies slipped off at the level of the glottis in 3 cases, they were then removed from the opposite bronchus (respiratory difficult syndrome developed in these cases); a thumbtack was removed by tracheotomy; one stone of apricot was removed through. An accurate pre-operative diagnosis is most important in operative management of cases of irregular shaped foreign bodies. General anesthesia, is usually. If the foreign body is too big to pass through the glottis, removing by tracheotomy should be considered.