A 56-year-old woman was transferred for the evaluation of a 5-cm long foreign body observed on simple abdominal radiography (Fig. 1A and 1B). She had undergone tracheostomy and gastrostomy owing to physical disability following cerebral hemorrhage 3 years. Her medical history recorded treatment with acupuncture around her mouth at the oriental medicine hospital. Abdominal computed tomography (CT) scan showed the linear radiopaque foreign body was inserted through the duodenum into the right renal cortex (Fig. 1C-1F). No free air or hematoma was observed on CT scan. Because the patient’s general condition is poor for surgery under general anesthesia, endoscopic removal of the foreign body was attempted. Handle of the acupuncture was observed in the distal end wall of the 2nd portion of the duodenum (Fig. 2A and 2B). Using rat-tooth forceps, the foreign body was grabbed and pulled down to the medial vertical as much as possible to minimize further damage. Subsequently, the needle was thin and folded by pulling the center into the endoscope cap. (Fig. 2C-2E) There was no perforation or hemorrhage other than a small ulcer at the site of removal. (Fig. 2F) The total length of the foreign body was 5 cm, with a 3-cm long thin needle and 2-cm long handle. (Fig. 2G and 2H) The patient was maintained on fasting for 2 days with the administration of antibiotics and proton pump inhibitors. She was discharged on the 4th day after the endoscopic removal of the foreign body.