Foreign body ingestion is a common occurrence in the pediatric population, especially in children less than 5 years old. The innate nature of the young to explore their environment can lead to dangerous ingestions. The clinical challenge is to predict which foreign bodies warrant removal because of risk for serious complications or a low likelihood of spontaneous passage. Lithium batteries, also known as button batteries (BBs), are not a new item, but the incidence of their ingestion is on the rise because of their increasingly common use in household products. In addition, the higher-capacitance 20-mm BB is more likely to lodge in the esophagus and increase morbidity and mortality. This article will describe the frequency of ingestion, which products contain BB, the signs and symptoms of ingestion, diagnostic imaging, mechanism of tissue injury, therapeutic management and intervention, and the complications that affect patient outcomes. The final discussion will address education and anticipatory guidance to prevent these harmful ingestions.