Radiographic imaging with barium sulfate swallow is a radiological procedure to investigate dysphagia and the sense of food sticking in throat. infrequently, application of the procedure causes barium aspiration. Due to the non-irritant structure of the barium sulfate it does not expected to cause severe lung injury. However there have been reported cases progressed to mortality of the patients. Here, we present two patients following inadvertent aspiration of large amounts of barium dining an upper gastrointestinal radiographic contrast study and presented with different clinical outcomes.