Objective: To define clinical spectrum of airway foreign body aspiration in children and to evaluate the outcome and complications. Methods: A total of 53 patients (27 girls, 26 boys) with a mean age of 30.0 +/- 32.7 months, who aspirated foreign bodies were treated with bronchoscopy were divided into two groups with respect to the time they were diagnosed as early (Group 1, n = 22, less than or equal to 24 h after aspiration) and late diagnosed group (Group 2, n = 31, > 24 h after aspiration). The two groups were followed up prospectively for complications. Results: A total of 72% of patients were under a 3-year age group. Choking episode history was reported in 32% of patients but when families were questioned about it more in detail the rate increased to 51%. Acute episode of choking seemed trivial most of the families. Cough (69.8%), decreased breath sounds (52.8%) and wheezing (45.1%) were predominant symptoms. Sunflower seed (32.1%) and peanuts (15.1%) were noted as common aspirated materials. Ar trapping (59%) and consolidation (47%) were the most frequent radiological findings especially in the late diagnosed group (P < 0.01). Patients who aspirated organic materials frequently developed pneumonia diagnosed in late period after aspiration. Conclusion: Pediatricians must be conscious to check for foreign body aspiration who have sudden onset of cough and wheezing episode. In any suspicion, a bronchoscopy should be considered even if there is not any positive history for aspiration. Children should be followed up after bronchoscopy for complications. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.