The development of heart block following cardiac penetrating injury is rare, and only few cases can be found in the literature. This uncommon healthcare emergency has shown to be a medical challenge for healthcare personnel, and it manifests very high mortality rates of 80–90% among its victims. The pre-hospital management and transport time for these cases are vital and can dictate the possible outcome for the victim. In this article, we present the first case ever reported in the Gulf Region about complete heart block as a consequence of penetrating chest injury. Our patient was a 35-year-old male who had a stab wound on the right side of chest wall and who developed complete heart block in the Emergency Department (ED) as a result of the injury. Patient was rapidly diagnosed and managed in ED and then was shifted to the operating theater for immediate surgical repair. However, despite anatomical correction during the surgery he remained hypotensive and bradycardic. When a hemodynamic stability was achieved, he was then placed on a temporary pacemaker and later on a permanent pacemaker by the cardiology team.