Tracheobronchial aspiration syndromes are the most important causes of accidental morbidity and mortality worldwide, particularly in infants. Children aged <2 yrs and individuals of any age with one or more predisposing risk factors, such as dysphagia, are the most vulnerable groups. As most aspiration events are unwitnessed, timely diagnosis relies on a high index of suspicion. The clinical presentation and radiographic features can vary depending on the nature and amount of the aspirated material or object. While a foreign body aspiration or a relatively large volume of aspirated material can cause an acute or subacute presentation ranging from choking and sudden death to acute pneumonia, repeated aspiration of gastric acid in small amounts can gradually progress to recurrent pneumonia, bronchiectasis or pulmonary fibrosis. Management varies depending on the clinical appearance (e. g. hypoxaemia or signs of infection) and the nature of the aspirated material (e. g. foreign body, gastric content or hydrocarbon). Bronchoscopy has a major role in the diagnosis and management of cases of foreign body aspiration.