Background: Retained rectal foreign body (RFB) is not an uncommon presentation in modern society, but no reviews have yet studied elderly specifically. Methods: An 10-year retrospective review was performed for all adult patients at MacKay Memorial Hospital with RFBs. All patients' demographic and clinical data were analyzed for differences between adult and elderly patients. Results: A total of 32 patients participated in the study. The mean age was 43.8 years and the majority were male. Foreign bodies other than vibrator were the most common foreign bodies retracted. Half of the patients refused to describe the reason for insertion. Radiologic examination was the primary diagnostic tool to detect RFBs, followed by digital rectal examination. RFBs could be extracted manually with or without local anesthesia in 75% of patients. Colorectal surgeons performed most of the extractions, followed by emergency physicians. After extraction, most patients (75%) were not admitted to the hospital and 65.6% did not attend a follow-up appointment at the surgical clinic. Adult and elderly patients differed only in age and reason for insertion. Transanal medication administration, anal medication and its accessory were more often found in the elderly group. Conclusion: Clinicians must speak respectfully and candidly with patients in order to build a trust-based relationship. Clinicians must provide patients with detailed instruction on the proper use of transanal medication. Emergency physicians must be familiar with the surgical and non-surgical management of RFBs. No clinical difference was found between adult and elderly patients except for the reason for insertion of RFB.