Patients with esophageal foreign bodies require prompt diagnosis and therapy. The proximal dilatation method using a video-mediastinoscope is safe and effective in removing sharp foreign bodies from the upper esophagus, avoiding surgery and possible perforation. The technique using a video-mediastinoscope proved to be effective and safe; this may be the first use of this procedure in the literature. We recommend using video-mediastinoscope for extracting foreign bodies involving the upper esophagus narrowing.