This case highlights a rare complication of endotracheal intubation: intestine perforation caused by an intubation-stylet fragment. A patient undergoing an appendectomy had an esophageal intubation on the first attempt and a successful endotracheal intubation on the second, using the same stylet. The missing fragment went unnoticed after intubation. Postoperative symptoms led to reimaging, revealing a foreign body in the intestine, later identified as a stylet fragment. The stylet fragment was removed, and the patient recovered by postoperative day 7. This case emphasizes the importance of vigilance in airway management, prompt evaluation of symptoms, and proper handling of damaged equipment.