Acquired tracheoesophageal fistulae (TEF) are rare and mostly a consequence of complicating malignant diseases, specific or nonspecific infections, esophageal diverticula, or trauma. In extremely rare instances an ingested foreign body may cause the development of a TEF. We recently managed an 11 month-old girl with a TEF and a history of foreign body ingestion 5 months prior to admission. She presented with recurrent antibiotic-resistant chest infections and in the last month dysphagia. The radiolucency of the foreign body, deficient follow-up, and an unprecise history at a later stage were the causes for delayed diagnosis and the development of this life-threatening complication.