Pneumatic nail guns are a tool used commonly in the construction industry and are widely available. Accidental injuries from nail guns are common, and several cases of suicide using a nail gun have been reported. Computed tomographic (CT) imaging, together with echocardiography, has been shown to be the gold standard for investigation of these cases. We present a case of a 55-year-old man who presented to the accident and emergency unit of a community hospital following an accidental pneumatic nail gun injury to his thorax. Volume-rendered CT of the thorax allowed an accurate assessment of the thoracic injuries sustained by this patient. As there was no evidence of any acute life-threatening injury, a sternotomy was avoided and the patient was observed closely until discharge. In conclusion, volume-rendered 3-dimensional CT can greatly help in the decision to avoid an unnecessary sternotomy in patients with a thoracic nail gun injury.