Foreign body aspiration (FBA) is one of the most frequent causes of endobronchial obstruction in childhood and a commonly encountered emergency in department of otolaryngology, especially in pediatric otolaryngology [1,2]. Children under 3 years old are mostly likely to be affected [[3], [4], [5]], with more males than females [3,6]. Organic materials, especially food, account for most of the aspirated foreign bodies [6,7]. The clinical manifestations of FBA can range from an asymptomatic presentation to a life-threatening emergency. When FBA occurs, rapid diagnosis and immediate foreign body removal is recommended [8,9]. Bronchoscopy is the mainstay in diagnosis and management of FBA. Rigid bronchoscopy (RB) has traditionally been the modality of choice. It has several advantages including large volume suction capability, good airway control and more therapeutic options. In addition, it is useful in cases of massive bleeding or central airway obstruction by large or sharp foreign bodies [10,11]. Flexible bronchoscopy (FB) allows better visualization of distal airways due to its low diameter and flexibility. It has been increasingly used since its advent, and several authors described FB as a diagnostic and therapeutic method for FBA [4,5,12,13]. RB has advantages in removing objects located in the thicker bronchial tree such as the trachea, while FB has advantages in removing objects located in the deeper or thinner bronchial tree such as grade III bronchus, the upper right or left bronchus and the basal segments of the lower lobes. So, patients with foreign bodies located in unilateral main bronchus are worthy of further study. More research is needed to compare RB and FB while choosing one versus the other for the management of FBA. This study focused on comparing clinical outcomes of RB and FB for foreign body removal in different airway locations, especially in unilateral main bronchus, in children, so as to provide some suggestions to assist clinical decisions.