<p>Foreign bodies (FB) in deep neck spaces such as the parapharyngeal space (PPS) are uncommon and pose diagnostic and surgical challenges. Most of the PPS foreign bodies have external penetrating mode of entry, rarely intraoral route of entry has been reported. Subsequent to lodgement, the FB can migrate to deeper tissue planes like parapharyngeal space, retropharyngeal space and mediastinum. Here we present a rare case of intra-oral entry of a foreign body and subsequent migration to left sided parapharyngeal space. A 2-year 6-month-old male child presented with a left sided neck swelling. The child had history of fall from the bed with a pen in the mouth, after which profuse oral bleeding had occurred one month back. The cap of the pen remained stuck in the lateral wall of oropharynx and migrated to deep parapharyngeal space causing prominence on the skin of the neck. Imaging revealed a 3.4&#xa0;cm x 1.1&#xa0;cm tubular non-organic foreign body in the post-styloid compartment of PPS, posterolateral to the left carotid space. It was medially related to the left external carotid artery, and the internal jugular vein was not visualized, suggesting compression. The foreign body was removed by transcervical approach under general anaesthesia. The FB was protruding behind the posterior border of sternocleidomastoid muscle (SCM). The left spinal accessory nerve (SAN) was identified early and was found displaced laterally due the FB migration. The FB was gently dissected from the surrounding fibrosis and removed in-toto. This case highlights the importance of considering deep space foreign body migration in paediatric oropharyngeal trauma. A thorough clinical history, appropriate imaging, and timely surgical intervention are essential to avoid serious complications. During surgical removal of deep neck space foreign bodies, forced manipulation should be avoided, and appropriate treatment should be administered after imaging.</p>