Emergency care of chest trauma has progressed greatly over the past two decades. Factors contributing to this progress include changes in the system for providing emergency medical services; the development of imaging diagnostic tools such as ultrasonography, computed tomography, magnetic resonance imaging, and computerized dynamic stereo radiography; advances in respiratory and circulatory care: and the spread of sophisticated methods of surgical management such as emergency room thoracotomy and thoracoscopic surgery. The vast majority of patients with chest trauma can be managed nonoperatively, with tube thoracostomy, pain control, chest physiotherapy, and medication. It is not unusual for pain relief or a single chest tube to improve a patient's condition dramatically. Therefore, every physician should know how to manage patients with chest trauma and how to make critical decisions as quickly as possible.