Background: Opening the chest is the accepted standard for a positive pericardial window in patients with wounds in the cardiac area, in all cases. However, in recent years there have been some reports of good results without opening the chest, only draining the hemopericardium in stable patients and nonpersistent hemopericardium. Selection should be made exclusively in patients with stable hemodynamics, without active bleeding, and without signs of tamponade, under controlled conditions with monitoring capacity and experience. Description of the case: A 23-year-old female patient is reported, with stab wounds in the precordial region who is admitted to emergency services. Patient with stable hemodynamics, it is decided to take a laparoscopic pericardial window to the operating room to rule out cardiac injury, evidencing nonactive bleeding from a cardiac injury, it is managed without opening the chest after washing the pericardium and evidencing that the bleeding subsides spontaneously. The patient was discharged without complications, documenting success with conservative management, and avoiding thoracotomy. Conclusion: The management of penetrating cardiac injury can be conservative without opening the chest in the stable patient, and the injury has stopped actively bleeding. Although this management is feasible, these cases should be managed only by experts and should not yet be considered as the standard, until sufficient evidence is obtained.