Abstract Background: In the acute context, spontaneous hemopneumothorax is a potentially life-threatening condition that can occur without any radiological abnormalities and may be caused by thoracic vascular aberrancy. Case presentation: We discuss the case of a healthy 24-year-old man who visited our emergency department complaining of left sided chest pain and shortness of breath. He had previously visited a tertiary care facility's emergency department for the same complaint the same day and had been released following a normal CXR and blood tests. His repeat CXR revealed hemopneumothorax in our department. His CT scan further revealed ruptured aberrant blood vessel which was medial to the left subclavian artery. Conclusion: This example case report illustrates the importance of maintaining a high index of suspicion for the probability of haemo or pneumothorax when evaluating patients who present with chest pain and shortness of breath. There must be a repeat patient examination and CXR for patients who experience prolonged chest discomfort, despite normal initial investigations. If the patient’s repeat x-rays indicate hemopneumothorax, this should leave one to ponder the likelihood that thoracic bleeding could result from vascular aberrancy. Keywords: chest pain, spontaneous hemopneumothorax, case report, thoracotomy and Chest X-ray.

Keywords: Keywords: chest pain, spontaneous hemopneumothorax, case report, thoracotomy and Chest X-ray.