Esophageal foreign body may cause severe complications such as esophageal ulceration, esophageal perforation, periesophagitis, tracheo-esophageal fistula, mediastinitis, pneumothorax, pyothorax according to the kinds, shape, size and duration of lodgement of foreign body. The complications of perforating foreign bodies could be broadly grouped into vascular, suppurative & miscellaneous types. Vascular complications has the highest rate and it is composed of aorto-esophageal fistula, innominate esophageal-fistula, carotid artery rupture etc. But cardiac tamponade is very rare. We experienced a rare case of esophageal foreign body in 2-yr old girl which caused cardiac tamponade after swallowing of metallic pin treated with emergency pericardiotomy and gastrostomy.