Cardiopulmonary resuscitation (CPR) is a life-sustaining technique for cardiac arrest that is not without its own risks. Myocardial puncture from traumatic CPR is a rare but serious potential complication of CPR that can lead to significant morbidity and mortality. Our case demonstrates posterior left ventricular wall perforation from a rib fracture during CPR and highlights the importance of post-CPR echocardiography in the assessment of CPR-associated cardiac injuries that may warrant intervention.