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Infants and young children are commonly referred for medical imaging for suspected aspirated or inhaled foreign bodies (Fbs). FB aspirations are potentially life-threatening and immediate diagnosis and treatment are vital to avert fatalities. Chest radiography is the first-line imaging method indicated to evaluate suspected aspirated FB. This can be supplemented with other medical imaging modalities, such as fluoroscopy, computed tomography (CT), and magnetic resonance imaging (MRI). However, the lack of specialised medical imaging modalities in developing countries impends timely diagnosis of aspirated FB. We report a case of a 7-year-old girl with airway metallic FB not visible on the initial chest radiograph. This case report highlights the challenges low-income health institutions are facing in the diagnosing of airway FBs and other complicated conditions which require advanced imaging. In the absence of specialised medical imaging modalities, radiographers and clinicians should have high indexes of suspicion to avert deaths. In addition, specialised training of radiographers in the absence of radio logists might contribute to improved patient outcomes. [ABSTRACT FROM AUTHOR]