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Metallic foreign bodies are rarely found in the maxillary sinus, and usually they have a dental origin. Two main surgical app-roaches are currently used for the removal of foreign bodies in the maxillary sinus: the bone flap and the endoscopic sinus tech-niques. However, the treatment is not only surgical removal. We are reporting one case of foreign body like a hand sewing needle entered into the maxillary sinus through an unusual route- carious deciduous molar tooth. It was diagnosed by three-dimensional images from cone-beam computed tomography (CBCT) and removed by a simple procedure, with magnetic iron, thereby avoiding the risk of damage to a large portion of the alveolar bone near the maxillary sinus. How to cite this article: Shao L, Qin X, Ma Y. Removal of Maxillary Sinus Metallic Foreign Body Like a Hand Sewing Needle by Magnetic Iron. Int J Clin Pediatr Dent 2014;7(1):61-64.