Background Foreign bodies (FBs) can cause obstruction, infection, or injury, yet comprehensive global assessments remain limited. This study evaluated the burden of FBs from 1990-2021, projected trends to 2050, and identified high-risk populations. Methods Using Global Burden of Disease 2021 data, we estimated age-standardized incidence ratio (ASIR), death ratio (ASDR), and disability-adjusted life years (DALYs) by age, sex, and region. Temporal trends were assessed with estimated annual percentage change (EAPC) and Joinpoint regression; projections applied Bayesian age-period-cohort models; decomposition quantified the effects of aging, population, and epidemiological change. Results From 1990-2021, global ASIR declined from 660.75 to 561.16 per 100,000 (EAPC: -0.84), ASDR from 2.11 to 1.41 (-1.47), and DALYs from 145.14 to 77.87 (-2.13). Males had consistently higher burden (2021: 725.96 versus 394.11 per 100,000 in females). Children under 5 and adults over 80 bore the highest risks, with intraocular FBs dominating incidence and pulmonary aspiration/airway FBs driving mortality. Western Europe had the highest ASIR, Andean Latin America the highest ASDR. Since 2019, the onset of the COVID-19 pandemic, intraocular FBs incidence has surged in East Asia, mainly China. Projections suggest ASIR will continue to rise through 2050, while ASDR and DALYs continue to decline, driven by global population growth (187.27%) and aging (46.82%) but offset by epidemiological improvements (-134.09%). Conclusions Despite long-term declines, FB incidence is rebounding, with marked disparities across sex, age, and region. Targeted interventions, including workplace safety, pediatric and geriatric care, and region-specific policies, are needed to mitigate risks and reduce inequalities.