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Background: Foreign body aspiration is a common life threatening emergency and easily preventable problem. Every year thousands of lives are endangered because of foreign body inhalation by children and teenagers. In Muslim nations, a unique group of population has recently been reported. This comprises young girls and women who put headscarf. Aim: This study presented an experience with scarf pin aspiration and discussed the unique clinical characteristics of this problem and challenges in management. Patients and methods: A prospective cohort study included 50 females with a history of scarf pin inhalation. This study was conducted in Cardiothoracic Surgery Department, Mansoura University Hospital after approval from the Research and Ethics Committee of Faculty of Medicine, Mansoura University from January 2017 to January 2019. Other forms of foreign body inhalation were excluded from this study. All patients underwent radiological work-up in the form of plain chest X-ray, both Postro-Anterior (PA) and lateral views, to confirm the presence of the pin within the tracheo-bronchial tree. Results: In one patient the pin was successfully removed Spontaneous by coughing, in 36 patients retrieved by rigid bronchoscope, In 6 patients the pin was removed by flexible bronchoscope in the same sitting. In 7 cases pin could not be retrieved at all because of penetration into lung parenchyma and hemorrhage due to initial manipulation. These patients managed by thoracotomy (5 cases of bronchotomy, 1 case of right lower lobectomy and 1 case of left lower lobectomy). Conclusion: The use of the scarf pin is a sociocultural practice that carries serious health risks in Egyptian Muslim females who wear Hijab. Rigid bronchoscopy is the preferred treatment modality.