Background <p>Penetrating neck injuries in the area between the clavicles and the cricoid cartilage sometimes cause intrathoracic problems such as pneumothorax or hemothorax. Injuries of subclavian vessels were reported as a cause of hemothorax caused by penetrating neck injuries. Coil embolization and hemostasis with electrocautery were reported as treatment. Herein we present a case of hemothorax caused by penetrating neck injury, which was treated with pleural dome laceration covering performed using video-assisted thoracic surgery.</p> Case presentation <p>A 68-year-old Japanese woman presented to our hospital after sustaining a self-inflicted stab wound to her left neck and chest with a kitchen knife. She was in hemorrhagic shock due to hemothorax caused by penetrating neck injury. We performed video-assisted thoracic surgery and stopped bleeding with pleural dome laceration covering. We chose the treatment instead of coil embolization or hemostasis with electrocautery because the bleeding vessel was unclear.</p> Conclusion <p>Pleural dome laceration covering was effective for hemothorax that was caused by penetrating neck injury when the bleeding vessel was unclear.</p>