Emergency thoracotomy is required in 10-15 per cent of all patients with thoracic injury. Nine specific indications for emergency thoracotomy have been described for injured persons. A variety of incisions is available to the surgeon, and selection of the appropriate incision is based on radiographic and clinical findings. Thoracotomy in the emergency room is occasionally indicated, but it should be performed only by surgically trained individuals. Patients requiring emergency thoracotomy who are not dead on arrival have a greater than 75 per cent chance of survival.