It is a case report of intravascular foreign body migrating from pharyx. The patient give no definite foreign body intake history and was misdiagnosed by community clinic, so failed initial treatment. It was a fish bone was found chest computed tomography (CT) unexpectedly and was successfully taken out through surgery. Some experience we?ve drawn from the case and would like share in this article. Upper aero-digestive foreign body is quiet common for otolaryngologist, especially among emergent cases. But for the foreign body migrated out of lumen into the neck soft tissue is rare event. Even some complications coursed by foreign body in this region can be fatal. In this article, we report a case with a pointed fishbone stuck in the Internal jugular vein.