Background: Penetrating brain injury is a rare entity. Furthermore, clinical presentation can be highly variable and management difficult, especially when the foreign body is retain in the skull Methods: We present a serie of three recent cases of penetrating brain injury that happened at our institutionm including clinical and radiological data. We discuss management of those challenging cases and present a brief review of the literature. Results: Our cases (3) encompassed different mechanisms: bilateral nail gun injury, knife and aircraft propeller. All patients were male, with a median age of 37 years old. Work-up was negative for intracranial vascular injury. All patients were treated with initial craniectomy (bilateral in one case) and a course of antibiotics. Cranioplasty was later performed. All patients survived and evolved in favorable fashion. Conclusions: Penetrating brain injury is a rare injury, requiring individualized surgical and medical management. A few recommendations may be found in the literature but are often based on literature from blunt traumatic brain injury or war-related injuries.