This review summarizes the epidemiology, diagnosis, and management of pediatric foreign body (FB) ingestion, with particular emphasis on circumstances that may require surgical involvement. Initial evaluation includes history taking, assessment of symptoms, and radiographic imaging to determine the type and location of the ingested object. Plain radiography remains the primary diagnostic modality for detecting radiopaque objects and localizing them within the gastrointestinal tract; however, additional imaging may be needed for radiolucent objects or when complications are suspected. Management depends on the anatomical location and characteristics of the FB. Esophageal FBs generally require urgent endoscopic removal, especially when button batteries, magnets, or sharp objects are involved. After an object has passed into the stomach, many cases can be managed conservatively; however, high-risk objects, including button batteries, multiple magnets, and long or sharp items, may require early removal. FBs beyond the pylorus usually pass spontaneously but require monitoring for complications. Surgical intervention may be necessary when endoscopic removal is not feasible or when complications such as obstruction, perforation, or fistula formation occur. This review summarizes location- and object-specific management strategies and identifies situations in which early surgical involvement may improve outcomes in children with FB ingestion.