The authors report successful surgical treatment of a through gunshot wound of the heart and aorta. Similar cases are extremely rare and often followed by unfavorable outcomes. There are few case reports in the literature. A 29-year-old man admitted after a suicide attempt with a powder-actuated tool in a shock state. Computed tomography revealed a dowel penetrating thoracic spine and abdominal aorta. Emergency closure of entrance and exit holes of the right ventricle and abdominal aorta resection with anastomosis in end-to-end fashion were carried out. The patient was discharged after 8 days. This case demonstrates successful surgical care at the modern stage.