Trauma is the leading cause of mortality globally.Penetrating chest trauma is a type ofinjury that occurs when an object pierces the skin and enters the chest wall. The incidence of penetrating chest trauma is high in the Khyber Pakhtunkhwa Province of Pakistan, with firearm injuries being the most common cause. The objective of this study is to determine the epidemiology and outcome of non-cardiac penetrating chest injuries presented at a tertiary care center in Peshawar. This retrospective cohort study was conducted from January 2022 to January 2023 at Medical Teaching Institute, Lady Reading Hospital, Peshawar, KPK, Pakistan. Two hundred and three patients who suffered penetrating chest trauma in the Khyber Province of Pakistan between January 2022 and January 2023 were included in this retrospective cohort study. The epidemiology and outcomes were analyzed using IBMSPSSStatistics for Windows, Version 23 (Released 2015; IBM Corp., Armonk, New York, United States). The mean age of the patients was 30.25 ± 16.674 years. Males comprised 183 (90.1%) of the study sample whereas females comprised only one-tenth 20 (9.9%). Gunshot injuries were the predominant mode of penetrating thoracic trauma comprising 128 (63.05%) of all injuries. Injuries inflicted by knife constituted approximately one-fifth of the presentations 44 (21.67%). The remaining injuries labeled 'Others' comprised modes such as road traffic accidents and fall injuries where the predominant mechanism was penetrating injury. The latter comprised 31 (15.27%) of the injuries. Penetrating chest trauma is common in the Khyber Pakhtunkhwa Province of Pakistan. Gunshot injury is the most common mode. Males are predominantly affected. Most non-cardiac penetrating chest trauma can be managed conservatively.