Foreign body aspiration occurs most commonly in children and can have serious consequences. In adults, it is associated with surgery, trauma and accidents. We report four unusual cases of foreign body inhalation. In one case a spike of wild barley entered the trachea through a tracheostomy cannula and migrated from the chest wall. In the second case a piece of coarse cloth which was introduced through a tracheostomy stoma aided by a wood sliver was retained in the trachea. In another patient an inhaled sewing needle migrated to the pericardium, and in the fourth case the head of a metal stud penetrated the trachea percutaneously through the neck and lodged in the right main bronchus. The incidence, causes, complications and management of such cases are discussed and the literature is briefly reviewed.