Percutaneous retrieval of intravascular foreign body is a safe and effective procedure with the use of various imaging modalities. However, fluoroscopy is used extensively in most of the procedures, because the broken fragments which gets retained in intravascular compartments are radiopaque. In our case, the broken fragment, which was retained in the internal jugular vein, was radiolucent. Retrieval of a radiolucent foreign body under fluoroscopy is not only difficult but also can lead to serious sequelae during retrieval. We report such a case of real time ultrasound-guided retrieval of the foreign body in adjunct with fluoroscopy. © 2012.