A retrospective review of the Greenville Memorial Hospital trauma registry revealed 70 patients admitted with sternal fractures over a 38-month period. Localized sternal tenderness was present in 68 (97.1%), external signs of contusion/ecchymosis in 33 (47.1%), and dyspnea in 10 (14.3%) patients. The mechanism of injury was motor vehicle crash in 64 (91.4%) patients, with 46 of these restrained. Isolated sternal fractures were present in 34 (48.6%) patients. Only one death occurred. All sternal fractures were managed with analgesia and rest; surgery was required only when indicated for associated injuries. No patient was found to have an aortic injury or clinically significant cardiac dysrhythmia. Conclusions in this study that differ from those in previous studies can possibly be attributed to an evolving mechanism of sternal injury. This retrospective review shows no association between sternal fracture and clinically significant cardiac injury or injury to the thoracic aorta.