The case presented describes a very rare cause of ‘needle-like’ chest pain in a 52-year-old Egyptian man. A sharp 38-mm long needle was detected in the lateral wall of the right ventricle (RV) by means of cardiac computed tomography (CT) scan. After heart team discussion, the patient underwent mininvasive cardiac surgery intervention. The needle was successfully removed though left minithoracotomy, and the patient was discharged home on the 5th day. The diagnosis of intracardiac foreign bodies may be challenging. The optimal treatment is still debated. Surgical or endovascular removal of penetrating cardiac foreign bodies should be carefully considered because of risk of potentially life-treating complications. The multidisciplinary team working should be encouraged to assess the balance of the risk/benefit ratio.