Penetrating head injury remains an important issue even in modern neurosurgery. Less frequent than other neurosurgical diseases, they may still pose some management problems. The authors present one extremely rare case of suicide attempt by penetrating head injury with harpoon at a male middle aged patient associated with iatrogenous pneumothorax. Operated with a simple occipital craniectomy, the patient had a pretty good recovery with minimal neurological deficit (facial paresis).