Objective To explore the clinical characteristics, diagnosis and perioperative management of bilateral bronchial foreign bodies in children so as to reduce the missed diagnosis and misdiagnosis, increase the curative rate and reduce the complications. Methods Clinical data of 25 children with bilateral bronchial foreign bodies were retrospectively analyzed, and the clinical features, surgical techniques and principles of diagnosis and treatment were summarized. Results Of all the 25 cases, 22 had the history of foreign body aspiration. Preoperative spiral computerized tomography (CT) 3D imaging was performed in 22 patients, and 3 cases didn't receive CT examination due to critical situation. The preoperative CT revealed bilateral bronchial foreign bodies in 10 cases and unilateral bronchial foreign body in 12. Successful foreign body retrieval by using rigid bronchoscope under general anesthesia was performed in all the patients. Bilateral bronchial foreign bodies were disclosed intraoperatively in the 12 with preoperatively-diagnosed unilateral bronchial foreign body. Conclusions With characteristics of short disease course, heavy clinical symptoms and short onset time of dyspnea, bilateral bronchial foreign bodies are easy to be misdiagnosed as unilateral bronchial or tracheal foreign body. The preliminary diagnosis of bilateral bronchial foreign bodies should be considered based on the emergence of cough and asthma as well as progressively aggravated dyspnea shortly after foreign body aspiration, the same or different degree of reduction of breath sounds in both lungs during auscultation, and imaging examination if possible. Foreign bodies should be removed by bronchoscopy as soon as possible to reduce the incidence of death and complications.