Aim: In this study, we aimed to determine the safety and feasibility of tube thoracostomy in the management of chest trauma and its impact on patient outcomes. Material and Methods: This retrospective study was conducted at the Department of Surgery, Northern Medical Tower, in Arar Kingdom of Saudi Arabia for 2 years from January 2019 to December 2020. Inclusion criteria were patients who presented to the Emergency Department with chest trauma due to a motor car accident (MCA), history of falls, history of assault, etc., and they were hemodynamically stable. Exclusion criteria were hemodynamically unstable patients with obvious signs of thoracotomy. Records of all patients with chest trauma were retrieved from files. The variables of the study were the demographic data, the mechanism of trauma, the clinical assessment of patients, the duration of the chest tube, length of stay in the hospital, complications, and clinical outcomes. Result: This study included 365 patients with chest trauma, 329 (90.14 %) males and 36 (9.86%) females with a ratio of M 9:1 F. The age of the patients ranged from 12 to 70 years with a mean age of (41.15 +/- 1.5) years. Road traffic accidents were the commonest mechanism in 300 (82.19%) patients with blunt chest trauma and a stab wound in penetrating chest trauma. Head and neck injuries were the most common associated injuries. Tube thoracostomy under local anesthesia was done in 98 (27%) patients, while 267 (73%) patients were managed conservatively. Discussion: Tube thoracostomy is a safe and feasible option in the management of chest trauma with better patient outcomes. Chest trauma resulting from road traffic accidents remains the major mechanism of chest injury among young males and active age groups.