A series of 55 cases of fish‐bone impaction of the pharynx and œsophagus is discussed. Special reference is made to the serious and sometimes fatal complications that may result from delay in treatment, and cases illustrating these complications are reported in detail.SummaryFifty‐five cases of fish‐bone impaction of the pharynx and the œsophagus are reported. Spontaneous disimpaction can occur. Persistent simple impaction, although distressing for the patient, is easily managed. Delay in treatment or well‐intentioned but inexpert attempts at dislodging the fish bone by the patient or his friends may result in perforation of the pharyngo‐œsophageal wall with retropharyngeal inflammation and suppuration, a condition carrying high morbidity. Perforation of the carotid artery or the aorta is a grave complication, requiring urgent treatment if a high mortality is to be avoided. A brief review is made of the complications of fish‐bone impaction in the abdominal part of the al