Migrated ingested foreign bodies from the upper digestive tract have the potential to cause life-threatening complications. Cases of spontaneous expulsion to the skin of the neck are very rare. We present an unusual case of an ingested foreign body that migrated out of the upper digestive tract and self-extruded via the skin of the neck. An approach to the safe management of such seemingly innocuous foreign bodies is discussed. This report highlights the message that unfound ingested foreign bodies should be treated seriously due to the possibility of migration and resulting complications.