Isolated injury to the internal mammary artery (IMA) is rare but potentially life-threatening if not promptly diagnosed and managed. Such injuries can result from penetrating or blunt trauma, or iatrogenic causes such as sternal wire insertion during cardiac surgery. Failure to identify and control the bleeding can lead to massive hemothorax, shock, and death. We present a case series of four patients with isolated IMA injuries following gunshot wounds, stab injuries, and cardiac surgery. Each case underscores the importance of early recognition, high clinical suspicion, and timely surgical intervention. Appropriate management through thoracotomy or sternotomy resulted in favorable outcomes in all cases. [ABSTRACT FROM AUTHOR]

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