Introduction: Foreign body ingestion occurs infrequently but can be associated with rare risks including perforation, it is a potentially harmful disease with a high-cost hospital presentation, rarely associated with perforation or adverse outcomes and increasing in frequency worldwide. Case Report: An 87-year-old female patient with a history of arterial hypertension, Parkinson's disease and diverticular disease, presented to a primary care unit with a 72-hour generalized abdominal pain, that was later accentuated at the left lower quadrant, accompanied by constipation, abdominal distension, and general malaise. Abdominal and pelvic CT revealed pneumoperitoneum, pericolic panniculitis at the left lower quadrant, free fluid at the pouch of Douglas and a radiopaque foreign body of approximately 5 cm, located of the transition of the descending and sigmoid colon. An exploratory laparotomy was performed, finding coproperitoneum along with colon perforation due to a metallic foreign body (metal hair bobby pin). Conclusions: Perforated viscus due to foreign body is an infrequent cause of acute abdomen, which must be evaluated according to the patient's characteristics. Diagnosis should be promptly made, through a detailed clinical history, including psychiatric disorders, and image methods, mainly CT.