Aims Superabsorbent polymer beads (aqua beads or expanding water-absorbing beads) are decorative household items that are easily accessible and easily mistaken as colourful toys by children. Cases of water beads ingestion, inhalation and insertion into the ear canals and nasal cavities are well known. This paper aims to comprehend the growing problem by exploring the breadth of literature to understand the clinical impact, provide clinical practice suggestions and postulate public health recommendations. Methodology Both scientific journals and grey paper literature search are undertaken, including literature review, case reports, news articles, product safety commission letters, in vitro studies and technical papers. Results There are 37 case reports, 7 case series, 9 retrospective observational or descriptive studies, 3 in-vitro analysis, 1 literature review, 4 cases in the news, and 1 US Consumer Product Safety Commission Letter pertaining to water beads. Based on cumulative data from various papers there have been 874 ingested cases and 49 inhaled cases reported. Three paediatric deaths accounted and one toxic encephalopathy. One database documents a total of 5805 cases reported to poison centres. Oral ingestion is the most common mechanism, followed by ear insertion and nasal insertion. The physicochemical properties differ depending on brands, some reaching 13.3mm at 5 hours or in others up to 50.3mm at 72 hours in water. Expansion in gastric content is reduced compared to water. They are not radioopaque and have been mistakenly reported as cysts on ultrasound. Conclusions Understanding the physicochemical properties of water beads is important for ENT surgeons managing accidental inhalation, insertion in ears and noses, or ingestion. Understanding the duration of expansion and physical bead properties will guide observation time, service provision and techniques of retrieval. A public health preventative approach should also be considered.