A 67-year-old obese woman with diabetes mellitus and a previous stroke was admitted to a local hospital under a diagnosis of urosepsis. In-hospital cardiac arrest occurred, and cardiac pulmonary resuscitation was successfully performed. She was later transferred to our emergency department where she presented with profound shock. Emergent central venous catheterization via the left subclavian vein was performed. A follow-up chest radiograph showed an unusual route of the catheter. We obtained a chest computed tomographic scan of the patient, and the reconstructed tomogram showed that the tip of the catheter had penetrated the main trunk of the pulmonary artery with mild hemopericardium. The patient did not present with significant pneumothorax. The catheter had punctured the thoracic cavity between the first and second ribs. After complete evaluation, the catheter was smoothly removed under the assistance of video-assisted thoracoscopic surgery by a chest surgeon.