A five year old boy was brought from the scene, presenting a penetrating injury on the left suprascapullar site caused by a foreign body, with exit wound found paraesternal in the 4th intercostal space. Prehospital team found a boy pinned down through an iron bar. Total prehospital time was 48 minutes. He arrived in the Emergency Room of the Pediatric Department of Santa Casa School of Medicine, Sao Paulo, Brazil. Primary Survey: A-patent airway / 96% pulse oxymetry; B-decreased breath sounds on the left side; ventilatory rate 28 breaths/min.; C-warm skin, cappilary refill<2 secs; pulse rate 110 beats/min; D-GCS ? 15 / pupils were equal and reactive to light. E-entrance wound: left suprascapullar site; exit wound: paraesternal/ 4th left intercostal space; the iron bar was in the site of penetration. FAST-no free fluid in the abdominal or pericardial sac evaluation. He was moved to the operating room to continue the assessment and management. There were no further injuries. Thoracoscopic procedure was the surgical option to do a simple extraction. Entrance and exit wounds were clearly seen and the procedure was considered safety enough with no bleeding site after the extration. A 26Fr chest tube was inserted in the 5th intercostal left space. The boy recovered and was discharged from hospital at the fourth postoperative day.