Background: Esophageal Foreign Body (EFB) ingestion is a frequent emergency, particularly in children and neurologicallyimpaired adults. In resource-limited settings like Eastern Nepal, optimal anaesthetic management remains challenging due toinfrastructure constraints and lack of standardized protocols.Methods: This observational study at a Nepalese tertiary hospital analysed 40 EFB cases (ages 1 to 75 years) over two months.Using convenience sampling, we documented anaesthetic techniques, airway management and outcomes through structuredinterviews and medical records.Results: Paediatric cases comprised 55% of presentations. Coins (27.5%), chicken bones (17.5%) and fish bones (15%) weremost common, primarily lodged in upper esophagus (37.5%). Intravenous anaesthesia (60%) surpassed general anaesthesia(40%), with nasopharyngeal tubes (65%) preferred over endotracheal intubation (35%). Propofol (75%) and fentanyl (55%) weremainstay medications. Mean procedure duration was 15 to 20 minutes with Para oxygenation in 67.5% cases. Complication ratewas 17.5% (desaturation 10%, laryngospasm 5%).Conclusion: Resource-adapted anaesthetic approaches demonstrated safety in EFB removal, though technique variabilityhighlights need for standardized protocols. Findings support context-specific guideline development for low-resource settings.