Chest trauma represents a significant challenge in critical care, necessitating prompt recognition and management to reduce morbidity and mortality. The complexities of thoracic injuries require a comprehensive understanding of pathophysiology, evidence-based interventions, and coordinated interdisciplinary care. This chapter provides an in-depth, algorithmic approach to managing chest trauma in the Intensive Care Unit (ICU), integrating the latest guidelines, advanced diagnostic modalities, and evolving therapeutic techniques to optimize patient outcomes [1, 2] [Ref: Algorithm 54.1].