Objective To investigate the characteristics, complications, and influencing factors of pediatric foreign body ingestion, providing clinical references for prevention and management. Methods A retrospective analysis was conducted on pediatric cases of foreign body ingestion treated at West China Hospital of Sichuan University between June 2007 and September 2019. Patients were stratified by age into ≤5 years, 6-10 years, and >10 years groups. Foreign body types, impaction sites, and complication rates were compared across age groups. Univariate analysis and multivariate logistic regression were performed to identify risk factors for complications. Results A total of 610 pediatric cases of foreign body ingestion were enrolled. Foreign body ingestion predominantly occurred in children ≤5 years (n=472, 77.38%), followed by 6-10 years (n=100, 16.39%) and >10 years (n=38, 6.23%). Foreign body types varied significantly by age (P<0.05): coins predominated in ≤5-year-olds (57.20%), while food-related objects were most common in >10-year-olds (52.63%). The most frequent impaction site was the upper esophagus, accounting for 48.31%, 44.00%, and 60.53% in the three age groups, respectively. Univariate analysis identified age, foreign body type, and location as significant predictors of complications (P<0.05). Multivariate logistic regression demonstrated that oropharynx and esophageal impaction (reference: stomach) [odds ratio (OR)=4.699, 95% confidence interval (CI) (2.456, 8.996), P<0.001] and high-risk foreign body types [OR=3.538, 95%CI (2.045, 6.122), P<0.001] were independent risk factors for complications, whereas increasing age had a protective effect [OR=0.418, 95%CI (0.252, 0.694), P=0.001]. Conclusions Younger children are at higher risk of foreign body ingestion, while increasing age is protective against complications. High-risk foreign body types and oropharynx and esophageal impaction significantly increase complication risks. Strengthening parental education, preventive measures against high-risk objects, and enhancing clinicians’ vigilance for complex cases are essential to reduce complications.