In the keel of Saudi German hospitals group to provide the best medical care to all nationals and residents. In the early morning, a Pakistani resident works as a carpenter after he was hit by a 10 cm nail that penetrated the chest wall from the left side to settle in the chest cavity near the heart . Our hospital received the patient by emergency and after performing the required radiology and locating the foreign body and under a general anesthetic in chest surgery room and with the use of endoscope to explore the chest from the left side and extract the nail and the patient out of the operations to the recovery room in preparation for transfer to the normal room