Pericardial rupture after blunt chest trauma is rare and is associated with a high mortality rate. We describe a patient with traumatic pericardial rupture and cardiac herniation who was successfully treated surgically. Traumatic pericardial rupture is difficult to diagnose preoperatively but should be suspected whenever there is severe blunt chest trauma. If pericardial rupture is not recognized and treated promptly it could be fatal owing to cardiac herniation.