A foreign body in the adult airway is a potentially life-threatening emergency without standardized treatment procedures. It manifests as chronic cough, shortness of breath, wheezing or recurrent obstructive pneumonia, with the most common location being the right main bronchus. Computed tomography (CT) is the first choice of imaging with a sensitivity of 98.8% and a specificity of 96.6%, but radiolucent materials can give false negative results, so high suspicion requires direct bronchoscopy. Flexible bronchoscopy under general anesthesia via a laryngeal mask achieves a success rate of over 90% for peripheral bodies, while rigid bronchoscopy is the gold standard for large, sharp, or proximal bodies. The instruments are chosen according to the body: forceps for metal/bone, loop for bulky objects, basket for smooth seeds, balloon for distal bodies after dilatation and cryoprobe for watery material such as blood clots or mucus. Release and extraction are done as a single maneuver under continuous visualization, hybrid rigid-flexible approaches reduce complications. It is recommended to consider a foreign body in unexplained chronic respiratory symptoms, with a flexible approach in stable patients and a rigid one for complex cases.