Chest trauma ranks third behind head and extremity trauma in major accidents in the United States. The motor vehicle accident is the most common etiology (70 per cent). Within the thorax, the chest wall itself is the most often injured. Many of these injuries are of moderate severity and rarely require surgical intervention. The majority of chest trauma requires careful surveillance to identify those patients who require operative correction. Improvement in vehicle safety, moderation of speed, and continued education should reduce the incidence and severity of chest trauma.