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Background: Penetrating chest trauma occurs internationally, and numerous studies on it have been found in the literature. Penetrating thoracic trauma (PTT) is a difficult problem, but fortunately most of these injuries can be treated without surgery. Objective: The current work aimed to evaluate factors that improve outcome of patients of penetrating chest injuries in Al-Azhar University Hospitals. Patients and Methods: A retrospective investigation conducted on (73) consecutive cases with penetrating chest trauma, mean age was (31.51±6.25) years, patients were divided into (13) patients presented with bullet injury and (60) patients presented with stab wound, Dissension of surgical intervention was done according to clinical examination, emergency laboratory and imaging investigations. Surgical approach depended on position, side, and type of trauma. Results: Relation between hospital stay and demographic data showed highly statistically significant differences as regard to age, type of trauma, unconsciousness, shock, echo and surgical procedure. Younger patients needed ≤7 days to improve. Also the majority of patients with stab trauma (45 patients out of 60 patients) improved within 7 days. Most of patients with unconsciousness needed >7 days to improve and also patients with repair surgery needed >7 days to improve. Conclusion: To improve outcome of patient with penetrating chest trauma, effort should be done for resuscitation of patient with early suspicion of danger of trauma with early laboratory and imaging investigation, to reduce the time from the trauma till operation with correction of any metabolic and laboratory abnormalities.