Sudden onset of breathlessness, wheeze, and cough with respiratory distress are the typical presentation of the foreign body aspiration. We are presenting a rare case of foreign body aspiration that has features of pneumothorax. An 8 year old male child complaining of the left sided dull aching constant chest pain 3 days prior to the presentation suddenly becomes drowsy and blue (cyanosed). At emergency SPO2 was 33 %. Urgent portable X-ray chest was done and left sided pneumothorax was detected. Urgent needle decompression was done, oxygen was given, and there was slight increase in the saturation. Patient was immediately shifted for the CT scan which showed foreign body in the left main bronchus with collapse of the left lung & pneumothorax. Consolidation was also seen in the right lower lobe possibly secondary to the aspiration. Bronchoscopic removal of the foreign body was done and it was found to be cap of a pen. Chest tube was inserted for the pneumothorax. Patient showed dramatic improvement immediately after the foreign body removal. Antibiotic for pneumonitis and other supportive therapy were given. Follow up CT after 6 days showed expanded left lung and resolution of the pneumonia on the right side. Very few literatures are available about foreign body aspiration presenting as pneumothorax and almost no literatures in our setting.