A 69-year-old Indonesian woman was discovered incidentally to have multiple fine small needles in the head and chest. They are known as charm needles, or ‘susuks’ in the Malay language, and are worn in the body as talismans. Inserting charm needles is encountered mainly in Southeast Asia and is related to traditional Malay beliefs, though the wearers also include Chinese and Indians.The needles do not cause pain or swelling and and are not visible externally. They should be left alone unless they lead to infection or interfere with surgical procedures or radiotherapy on the face and neck