Lesions due to impalement are uncommon, and usually result from a combination of blunt and penetrating trauma. Frequently their management is a complex surgical problem. There is a risk of inadequate management, which may result in fatal bleeding. In order to minimize blood loss and prevent exsanguination, the foreign body must remain at the site of the injury during the initial care. The safe removal of the impaling object depends on the expertise of the surgeon, who should study the path followed by the object, and perform the surgery under direct visualization. Swiftness of surgical management depends on worsening of clinical picture and on anatomy of the site where the impalement occurred. Sometimes impaled objects is causing tamponade of injured blood vessels, such that the uncautious manipulation and/or removal of the object, without adequate control/protection of adjacent vulnerable organs, may be hazardous. Some imaging tests can be helpful in preoperative study, allowing a strategy to prevent and control bleeding. Following cases will illustrate surgical management of impalement injuries: A man injured with iron bars.; A women admitted with a knife introduced in her face.; A man with knife fixed at his back in the region of the first and second lumbar vertebrae.