Intrapleural foreign body is an uncommon condition, usually encountered in the setting of thoracic trauma, but can rarely complicate diagnostic procedures such as thoracentesis. The management involves urgent identification and removal of the foreign body. Although surgical extraction using thoracotomy or video-assisted thoracoscopic surgery under general anesthesia constitutes the primary management strategy, intrapleural foreign body can also be removed using medical thoracoscopy. Herein, we report the successful removal of 2 intrapleural foreign bodies using a rigid thoracoscope under local anesthesia and conscious sedation. We also performed a systematic review of the literature describing the use of medical thoracoscopy in the retrieval of an intrapleural foreign body.