Migratory foreign body liver abscess is a rare presentation of all cases of guts ingestion of foreign bodies. Different pathogenic mechanisms make it unique among the general population of liver abscess. Fever and abdominal pain are typical reported symptoms; however, most patients cannot remember the ingestion event. Foreign body removal and adequate infection control are the fundamental treatments. We report a case of migratory foreign body liver abscess which was successfully cured by endoscopic removal of a toothpick in the stomach. (J Intern Med Taiwan 2022; 33: 64-69)