A retrospective chart review identified 113 children with esophageal coin impaction and analyzed their epidemiology and management. 55% of the children were male, and their mean age was 2.9 years. 65% had swallowed a penny, 80% had impaction of the proximal esophagus and 91% required a procedure to remove the coin. No relationship was found between the type of coin swallowed and the location of the impaction.