Cardiac tamponade is a life-threatening emergency, caused by an abnormal increase in fluid accumulation in the pericardium impeding cardiac filling. Cardiac tamponade is essentially a clinical diagnosis. Echocardiography is the test of choice when tamponade is clinically suspected. We report a case of successful management of traumatic cardiac tamponade. The patient was hemodynamically unstable, although chest radiograph and ultrasound showed only mild to moderate fluid collection. Transthoracic echocardiography helped confirm the diagnosis. The report emphasizes the importance of high possibility of cardiac tamponade in patients with penetrating chest injuries. It also highlights the value of echocardiography in the emergency room.