Esophageal foreign bodies constitute a formidable chapter of pathology, especially due to the nature of the complications that may appear in the evolution of such cases, some even life-threatening. The blockage and eventual enclavation of a foreign body at the level of the esophagus can occur following the voluntary or involuntary ingestion of various particles, organic or inorganic, on a previously healthy esophagus or on a pathological one, which presents stenoses of various etiologies. In the case of aggravation of the local situation or in the conditions of a neglected foreign body, the extension of the lesions leads to the appearance of esophageal perforation and cervical, thoracic or abdominal periesophagitis, with possible complications that are difficult to control, such as cervico-mediastinitis, which is a serious condition that endangers the patient’s life. The authors aim to discuss the case of a patient who presented to the clinic seven days after the ingestion of a fish bone, embedded in the upper part of the esophagus and complicated with perforation of the esophageal wall. The clinical aspects encountered, the difficulties of visualization and extraction of the foreign body, as well as the particularities of therapeutic management related to the therapeutic conduct applied to esophageal foreign bodies in general are presented, commented and emphasized. Rapid diagnosis, prompt surgical intervention (endoscopically or, if necessary, through an external approach), immediate reaction in the event of complications and follow-up of the patient are essential for the successful resolution of such a pathology.