A retrospective analysis of 56 button (miniature) battery ingestions was conducted. This represents the largest series in the literature studying this problem. Impaction of these foreign bodies, most frequently in the esophagus (five cases), was a uniform predictor of severe morbidity. In the remaining 51 cases, the battery traversed the esophagus without incident; only four of these ingestions produced symptoms, and there was only one case with any severe complications. In 33 asymptomatic patients, the battery passed spontaneously through the gastrointestinal tract. Fourteen patients underwent endoscopic or operative procedures or both despite the absence of symptoms. Unanticipated mucosal erosions were noted in seven of these patients, although no symptoms or sequelae developed. Initial chest roentgenogram and observation for symptoms will detect ingestors at risk of complications. Operative or endoscopic intervention should be withheld in the absence of these clinical indicators. Button batteries can routinely be allowed to pass spontaneously.