A prospective, case-control study was performed to describe the role that siblings play in foreign bodies of the head and neck and to recognize situations in which children are most at risk for foreign bodies. Any child or adolescent (0 to 17 years old) with a foreign body removed from the head or neck was included. The data collected included location of the foreign body, location of acquisition (e.g., home), and the number of and ages of siblings. Controls were matched by age, sex, and location of removal (clinic, operating room, or emergency department). Thirty-four patients were enrolled (20 male, 14 female). The average age was 5.25 years (range: 10 months to 15 years). The average age of patients with foreign bodies in the ear was 5.98 years (n = 23), esophagus 4.34 years (n = 6), and nose 2.97 years (n = 5). Nineteen (56%) of the foreign bodies were acquired at home and 17 (50%) under supervision by parents. Children with a younger sibling have a significantly increased risk of acquiring a foreign body compared with children without a younger sibling (odds ratio = 4.00, p = 0.04). We conclude that although acquisition of foreign bodies should become less common as children mature, older siblings (i.e., children who have a younger sibling) are at increased risk for foreign body acquisition. Most foreign bodies are acquired at home under supervision by parents. Increased awareness of this finding may help prevent foreign bodies in the head and neck.