Pediatric thoracic trauma, though relatively uncommon, carries a high risk of morbidity and mortality and poses unique challenges in assessment and management. Unlike adults, children have pliable rib cages and distinct physiological responses that can mask serious underlying injuries despite minimal external signs. This chapter provides a structured, practical approach to the initial evaluation and management of thoracic trauma in children, with a focus on the role of the primary care provider (PCP) in resource-limited and emergency settings. Using the Pediatric Assessment Triangle (PAT) and the ABCDE primary survey framework, the chapter guides providers in identifying life-threatening injuries such as tension pneumothorax, open pneumothorax, massive hemothorax, flail chest, pulmonary contusions, and cardiac tamponade. It emphasizes the importance of early oxygenation, rapid assessment, and prompt initiation of appropriate interventions, including oxygen therapy, pain management, and preparation for definitive procedures such as chest tube insertion. Special attention is given to the distinct anatomical and physiological considerations in children that influence trauma response and outcomes. The role of the PCP extends beyond stabilization to include team communication using SBAR, family education, and procedural assistance. Additionally, the chapter outlines strategies to help PCPs speak up within the trauma team, document care clearly, and engage families in understanding the injury and recovery process. Through practical guidance, reflective case scenarios, and structured management protocols, this chapter equips frontline providers to act confidently in pediatric chest trauma scenarios. It aims to empower PCPs to deliver timely, effective care, ultimately improving outcomes for young trauma victims.