A 48-year-old male was transported to the emergency room with a dirty rusty nail stuck in his chest. Three-dimensional computed tomography (3D-CT) scan revealed that the nail had penetrated the sternum and its tip was close to the left innominate vein. Emergency surgery was performed to avoid severe infections and major vascular injury. The nail was easily removed. We cleansed and debrided the wound which remained open to prevent infection, and was closed on post-operative day 3.