CASE PRESENTATION: A 70-year-old female patient presented to our interventional pulmonary clinic after three months of with progressively worsening dyspnea after accidental aspiration of an iron pill. She underwent a work up that included chest computerized, and flexible bronchoscopy that showed an ovoid lesion in of bronchus intermedius without evidence of airway stenosis. Her physical examination was notable for right sided inspiratory and expiratory wheezing. We performed a flexible and rigid bronchoscopy, which showed a near complete obstruction of the BI behind a pearly ovoid lesion (figure 1A-B). The stenotic lesion was inflammatory, fibrotic and circumferential. Endobronchial biopsies were performed and airway intervention was performed using fogarty and controlled radial expansion balloon dilation followed by rigid bronchoscopy dilation. Given the complex nature of the stenosis, a silicone stent was deployed in the BI. (figure 1C and 1D). The procedure was uneventful. Pathologic examination revealed subepithelial bronchial metaplasia, acute on chronic inflammation and subepithelial foreign body giant cell reaction. These findings were consistent with the diagnosis of iron pill aspiration induced bronchial stricture. The stent was in place for year with regular follow up. After one year the stent was removed, the bronchus intermedius was about 50% narrowed post stent removal and right middle lobe bronchus and right lower lobe bronchus were normal (figure 2). The patient remains asymptomatic and no resetting was needed 3 months post stent removal.