Traumatic air embolism is rare in Australia, but must be treated promptly if patients are to survive. A single fatal case of traumatic air embolism due to penetrating trauma is described with attention to the presenting symptoms and signs, the unsuccessful attempts at resuscitation and correlation with the post-mortem findings. Patients with penetrating chest trauma are at high risk of traumatic air embolism and positive pressure ventilation of the affected lung will cause rapid death if the condition is not immediately recognized. Early aggressive treatment is therefore necessary for survival. The diagnosis can be missed at post-mortem if not specifically sought.