South Western Ambulance Service said medics were called after an angler received the shock of his life when he attempted kiss a 15-centimetre Dover sole fish in celebration before it jumped down his throat.
The 28-year-old fisherman caught the prized fish off a pier in Bournemouth, southern England, and as tradition decided to kiss his prize.
However, the Dover managed to wriggle out of his hands and jump down the his throat stopping his breathing and causing cardiac arrest.
Friends attempted to resuscitate the 28-year-old before paramedics were able to pull the 15cm fish from the man's throat and save his life.
"It was clear that we needed to get the fish out or this patient was not going to survive the short journey to Royal Bournemouth Hospital," ambulance paramedic Matt Harrison told the BBC.
"I was acutely aware that I only had one attempt at getting this right as if I lost grip or a piece broke off and it slid further out of sight then there was nothing more that we could have done to retrieve the obstruction."
Paramedic Matt Harrison said he tried to remove the fish with forceps "although the fish's barbs and gills were getting stuck on the way back up". On the sixth attempt he managed to extract it whole.
The ambulance service said the man, who has not been identified, suffered "no lasting effects" from the mishap.