Objective: To explore the clinical characteristics and the pulmonary imaging and bronchoscopic characteristics of children with a bronchial foreign body and report the advantages of using a fiber bronchoscope (FB) for its diagnosis and removal.A systematic analysis was conducted regarding the clinical characteristics, pulmonary imaging findings, bronchoscopic placement, type of foreign body, and mucosal changes after airway disruption from a foreign body.Methods: The study group comprised 54 children (age: 0-7 years) whose foreign bodies were confirmed and removed by FB in the pediatric bronchoscopy room of Shengjing Hospital of China Medical University from September 2014 to August 2015.Resu1ts: Of the 54 patients, 35 (65%) were male and 19 (35%) were female;the median age was 22 months (range: 17-25.5 months), and 45 (83%) were under 3 years of age.Cough and/or gasping were main symptom.Normal breath sounds, wheezing, weakened breath sounds on the affected side and moist rales were main clinical signs.There was a lack of specific findings in pulmonary imaging characteristics of most cases.With bronchoscopy, granulation tissue surrounding the foreign body was observed in 42 cases (78%) and the time of foreign body inhalation slightly correlated with the severity of granulation hyperplasia (r =0.44;P=0.001).The main adverse reactions occurring during surgery were hypoxia (3 cases;6%).Conclusions: For the diagnosis of a foreign body in children, FB under local anesthesia has higher accuracy than other methods, and it is a safe and effective means to remove a bronchial foreign.