BACKGROUND: Foreign body inhalation, a surgical emergency requiring prompt management to avoid morbidity and mortality , poses a diagnostic and management challenge to otolaryngologists. OBJECTIVE: To assess the pattern of foreign body inhalation at the ENT Unit Korle Bu Teaching Hospital Accra, Ghana. METHODS: The theatre records of patients managed for foreign body inhalation from Ist January 2003–31st December 2006 at the ENT Unit of the Korle Bu Teaching Hospital Accra, Ghana were studied with respect to age, sex, clinical presentation, types of foreign bodies removed, location of foreign bodies, and outcomes of the laryngoscopy or bronchoscopy procedures. RESULTS: There were forty patients with an age range of seven months to 15 years with a mean age of 4.78 years and a peak age incidence at zero–four year age group. The commonest inhaled foreign bodies included groundnuts in five (12.5%) patients, fish bones in six (15%) patients, plastic materials in five (12.5%) patients, metal material in five (12.5%) patients and seeds in five (12.5%) patients. The common clinical presentations included respiratory difficulty, irritating cough, choking, painful swallowing and whistling sound during breathing. Foreign bodies were localized in the right main bronchus in 27 (67.5 %) patients, and in the left main bronchus in ten (25%) patients and in the larynx in three (7.5%) patients. One patient died during bronchoscopy and another patient had bronchotomy for failed bronchoscopy. CONCLUSION: The peak age of occurrence of forein body inhalation is in the zero-four year age group. The commonest inhaled foreign bodies are groundnuts, fish bones, plastic materials, metal materials and seeds. Majority of inhaled foreign bodies tend to localise in the right main bronchus. WAJM 2009; 28(6): 368–370.