Penetrating injuries of the neck are a cause of retropharyngeal abscess. Should a foreign body become lodged in the retropharyngeal tissues its removal may avoid this complication, but surgery can in itself be hazardous. Between 10 and 15 per cent of cases of retropharyngeal cellulitis resulting from whatever cause do not progress to abscess formation if treated conservatively. Consequently, it is important to have evidence of abscess formation before surgery is undertaken, as illustrated by this paper in the form of a case report and a review of the current literature.