Penetrating neck injury is an emergency requiring urgent radiological and surgical attention. Delay in treatment results in significant morbidity and mortality. While computed tomography angiography (CTA) is a commonly used diagnostic tool, it has limitations and may fail to detect high-density foreign bodies or active bleeding due to compression by blood clots. Here, we present a case of a 39-year-old male with a penetrating neck injury complicated by vascular injury secondary to unrevealed foreign body. Despite being haemodynamically stable and CTA suggesting vascular injury without active bleeding, exploration of the neck revealed multiple puncture wounds with bamboo fragments penetrating the left external jugular vein (EJV) and internal jugular vein (IJV). Haemostasis was achieved by ligation of left IJV and EJV. Maintaining a high index of suspicion and anticipating intraoperative haemorrhage are critical aspects of managing any penetrating neck wound.
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