Endotracheal intubation is common in the emergency department, intensive care units, and operating rooms. It involves the insertion of an endotracheal tube (ETT) through the mouth or nose into the trachea to maintain a patent airway and facilitate mechanical ventilation. Using a stylet during intubation can guide the ETT through the vocal cords. However, complications can arise when the stylet is not removed after successful intubation. Herewith, we reported a patient who was two years old and suffered from respiratory failure. However, in the first 12 hours, we observed a foreign body in the trachea, a small end of a metal stylet immediately removed by bronchoscope. This case demonstrates that multiple uses of a stylet, especially by a single user, can result in impaction of the stylet in the ETT during intubation, requiring force when the stylet is withdrawn after intubation, which can result in breakage, shearing, and retention of the stylet or plastic sheath in the lumen of the ETT.