Abdominal radiographs, which revealed that the needle was on the right side of the third lumbar spine vertebra. The symptoms and signs of a retained surgical item include adhesion, foreign body migration, visceral perforation, and abscess formation [1]. These symptoms can occur early in the postoperative period or may develop after months or years [5]. In prior instances, retained surgical suture needles were surgically removed. However, our patient developed symptoms and signs of a retained needle 28 years after his surgery, by which point the needle had migrated to the ampulla of vater, from where it was easily removed through ERCP. Migrated surgical clips, stents, gauze pieces, suture materials, and fragments of t-tubes have all been reported as retained iatrogenic foreign bodies causing CBD obstruction and subsequent sequelae [2]. To our knowledge, this is the first reported case in which a retained surgical needle migrated to the ampulla of vater. Needles comprise 0.06–0.11% of foreign bodies that are retained during surgery [7]. Preventing instances of unintentionally retained surgical materials is a critical problem. A nationwide Brazilian study of retained surgical foreign bodies reported that challenging medical situations, security protocol omission, and inadequate work conditions contributed to retained foreign bodies. Sponges are notoriously overlooked because they are routinely inserted into cavities to expose the operative field. Thus, a preventive protocol could involve the introduction of the use of sponge-holding forceps [8]. In conclusion, CBD obstruction caused by foreign bodies can be safely ameliorated through ERCP without complications noted during follow-up.