Abstract Thirty consecutive patients with penetrating cardiac wounds were treated surgically during a period of 6.5 years. There were 6 deaths, giving a survival rate of 80 per cent. Delay in undertaking repair was associated with a friable myocardium. Cardiac arrest, either before or during operation, occurred in 5 patients, 4 of whom subsequently died. Left ventricular wounds were associated with a higher mortality than those affecting the right ventricle. Perforating cardiac injuries had a mortality of 43 per cent in comparison with 13 per cent for penetrating injuries. Coexistent intraperitoneal injuries were present in 4 patients, 2 of whom underwent successful repair.