Gastrointestinal foreign bodies are a common problem. It can be managed by observation, endoscopic removal, and/or surgical intervention. Bowel perforation, obstruction, bleeding, fistularization and abscess formation are common significant complications associated with foreign bodies. A 38-year-old woman with a toothbrush in the duodenum was referred to our hospital due to abdominal pain. Three years ago, she ingested a tooth brush. Esophagogastroduodenoscopy showed a tooth brush placed in the second portion of the duodenum. We removed a tooth brush by a snare and found a fistula at the junction of the second and third portion of the duodenum. Upper gastrointestinal series revealed a fistula between the duodenum and cecum. We report a case of duodeno-cecal fistula developed due to a toothbrush ingested 3 years before. (Korean J Gastrointest Endosc 2003;27:4245)