Blunt or nonpenetrating chest injuries are common after motor vehicle accidents or falls. Blunt injury to the heart ranges from contusion to rupture. Cardiac rupture, however, is uncommon and associated with a very high mortality rate ; left ventricular rupture due to falling is even more rare. We experienced a case of left ventricular rupture of the heart caused by a fall, which the patient survived. A 63-year-old man fell off a ladder and presented with hypotension from left hemothorax and pericardial tamponade. The hemothorax was relieved via an emergency closed thoracostomy but dyspnea and hypotension continued. And so, echocardio graphy was done and pericardial tamponade was detected. Emergency left thoracotomy was done to repair the rupture site. We believe that patients with cardiac rupture who reach the hospital alive can often be saved by prompt diagnosis and immediate surgical treatment.