Injuries to the pectoralis major muscle are relatively rare but result in pain, weakness, cosmetic deformity and in many cases, inability to return to previous levels of function. The most common cause of this injury is bench-pressing, as it places the muscle fibers in a position of mechanical disadvantage while under heavy load. The ability to detect and appropriately treat each patient with this injury is essential to restoring not only strength and function but also cosmesis. This article reviews the diagnostic workup of this injury and examines both the outcomes and techniques of non-operative and operative management.