Objective To investigate clinical features, diagnosis, clearance strategies and prognosis of intracranial foreign bodies. Methods Twenty patients with intracranial foreign bodies were analyzed retrospectively, together with review of the related literatures. Results Twenty patients underwent craniotomy for intracranial foreign body removal under guidance of preoperative CT and X-ray localizations and intraoperative C-arm X-ray machine and ultrasound localizations. A total of 35 foreign bodies were removed. One patient underwent second surgical resection after the incomplete removal due to displacement of intracranial foreign bodies. According to Glasgow outcome score (GOS) at discharge, the outcomes were good （GOS=4-5 points） in 16 patients, poor (GOS=2-3 points) in three and death (GOS=1 point) in one. Conclusions CT and X-ray locations before surgery and C-arm X-ray machine and ultrasound locations in operation avail the removal of foreign bodies by craniotomy. In the meantime, prognosis is satisfactory.