Accidental penetrating injury to neck is uncommon. Because of location of important vital structures, any injury in this area should be timely diagnosed and managed. Over the years a remarkable number of changes have occurred in the treatment paradigm of such injuries. An evolution from no treatment, to routine exploration and now to selective exploration has occurred because of better diagnostic and surgical skills. We report an interesting unusual case of removal of 10cm metallic screw from the mandibular area and neck area. Close proximity of such a rigid and sharp metallic body to neurovascular structures, airway and esophagus, posed a unique management challenge.