Abstract <p>Pediatric battery ingestion can result in serious complications and mortality. We aimed to determine the incidence and complication rate of pediatric battery ingestion in the Netherlands. Cases of pediatric battery ingestion, including patient characteristics, battery characteristics, complications and interventions (2018–2021) were prospectively reported by pediatricians using the Dutch Pediatric Surveillance System and combined with population-related data of Statistics Netherlands. Follow-up data were assessed by standardized questionnaires. In total, 153 episodes of ≥ 1 battery ingestion were reported (49.7% female, median age 2.8&#xa0;years). An average of 38 episodes per year, reflecting an incidence of 1.18 episodes per 100,000 children per year was found. Most ingested batteries (87.6%) were button batteries. Complications occurred in 26 (17.0%) of battery ingestions. Severe complications were mortality following esophageal-aortal fistula causing hemorrhagic shock (<i>n</i> = 1; 0.7%), carotid artery bleeding (<i>n</i> = 1; 0.7%), tracheal-esophageal fistula (<i>n</i> = 1; 0.7%) and (pneumo)mediastinitis (<i>n</i> = 2; 1.3%). In most cases, batteries were ingested as loose items (<i>n</i> = 47; 30.7%), or as components of lights (<i>n</i> = 25; 16.3%) and toys (<i>n</i> = 22; 14.4%). Complications were significantly associated with younger age (<i>p</i> 0.004), symptoms at first presentation (<i>p</i> &lt; 0.001), larger batteries (<i>p</i> 0.021), and location in the upper (<i>p</i> &lt; 0.001) and middle third part (<i>p</i> 0.037) of the esophagus.</p> Conclusion <p>The population-related incidence of pediatric battery ingestion is 1.18 episodes per 100,000 children per year in the Netherlands with 17% complications. Battery swallowing in young children is a life-threatening emergency—urgent action and increased awareness among politicians, industry and healthcare professionals are essential to prevent serious harm.<Table Float="No" ID="Taba"> <tgroup cols="2"> <colspec align="left" colname="c1" colnum="1" /> <colspec align="left" colname="c2" colnum="2" /> <tbody> <row> <entry nameend="c2" namest="c1"> <p><b>What is Known:</b></p> <p>• <i>Battery ingestion can lead to severe complications and mortality.</i></p> <p>• <i>Young children are prone to accidental button battery ingestion due to oral exploration.</i></p> <p>• <i>Esophageal impaction and related complications are more common in children compared to adults due to small anatomy.</i></p> </entry> </row> <row> <entry nameend="c2" namest="c1"> <p><b>What is New:</b></p> <p>• <i>The incidence rate of pediatric battery ingestion is rarely described worldwide. In the Netherlands, the incidence is 1.18 per 100,000 children per year.</i></p> <p>• <i>Unfortunately, complications are relatively often after ingestion (17%).</i></p> </entry> </row> </tbody> </tgroup> </Table></p>