The cases of foreign body aspiration constitute a significant proportion of emergency cases that present to emergency departments around the clock. These cases demand quick management and wisdom to decide the therapeutic procedure, in order to achieve a delicate balance between the need for endoscopy on the one hand and the complications due to endoscopy or the delay of it on the other hand. The possibility of reaching an algorithm based on a combinatorial approach that encompasses evaluation of clinical findings along with investigations will help to increase the accuracy of decision making process and reduce complications. To outline helpful measures in the management of suspected cases of foreign-body aspirations in order to increase the accuracy of bronchoscopy indications, and thus decrease negative bronchoscopies and also reduce morbidity and mortality associated with suspected aspiration’s cases.