The authors describe four cases of penetrating heart wounds: two from slash and puncture injuries and two from gunshot. Hearth lesions involved the left ventricle and pericardium in two cases, the right ventricle in one case, and only the diaphragmatic pericardium in one case. After a review of the literature, the authors discuss clinical and diagnostic problems relative to penetrating chest wounds and particularly those of the heart, stressing the need for very prompt diagnosis; as for actual treatment, they conclude that this can be carried out without any special problems in any Department of general emergency surgery.