Ingested gastrointestinal foreign bodies may be managed by observation, endoscopy, and/or surgical intervention. We retrospectively reviewed 87 consecutive cases of foreign body ingestion. In 49 patients the ingested foreign body had passed beyond the gastroesophageal junction, and these cases form the basis of this study. Of the 49 patients, 19 (38.7%) required surgical intervention for removal of the swallowed object. Nearly 75% of these patients had swallowed objects that were more than 6.5 cm in length. Of 30 adults, more than 50% required surgery for removal of the foreign body. However, fewer than 16% of children who had swallowed and retained foreign bodies required surgery for ultimate cure. Based on these findings, guidelines are presented for the management of foreign body ingestion.