An acute collapse calls for urgent and appropriate action. Yet, it is difficult to have a comprehensive differential diagnosis in such a situation. Foreign body aspiration is a major cause of collapse that should be considered. Prompt diagnosis and early focused intervention are crucial for outcome. In the two cases described here, there was a collapse due to foreign body aspiration. In the first case, a 56-year-old female was found while losing consciousness. The cause of her collapse was not immediately clear and extensive diagnostics did not reveal the cause. After extubation the anamnesis eventually brought clarification and yielded the diagnosis of aspiration. In the second case, an 83-year-old female was suddenly seen motionless in her chair. Her family told attending paramedics that she often choked on food so that they could remove the obstructing food remnants from the pharynx. Collapse as presentation of a foreign body aspiration is rare. In a complete closure of the airway, there is no possibility for speaking or breathing and unconsciousness soon follows. Confusion with a cardiac event, known as the cafe coronary, frequently occurs. More commonly a partial obstruction of the airway occurs and symptoms mostly include cough, dyspnoea, vomiting and wheezing. In an asphyxiating foreign body aspiration immediate actions are vital, however, the possibility of choking in collapse is not always considered. When suspecting a foreign body aspiration in a case of collapse, removing the object that obstructs the airway and re-establishing an airway has priority. The gold standard in treating an asphyxiating foreign body aspiration is rigid bronchoscopy.