Cardiac contusion is a potential complication of blunt chest trauma and can be detected in a variable percentage of cases, depending on the method of diagnosis employed. Mechanical and/or ischemic mechanisms may be involved in the occurrence of myocardial injury in patients with cardiac contusion. In the reported case, cardiac magnetic resonance (CMR) was performed late after chest trauma in a 17-year-old man involved in a car accident 4 years earlier. CMR images documented the persistence of severe regional dysfunction involving the left ventricle, associated with a large area of post-contrast myocardial enhancement (representing necrosis and/or fibrosis). Functional and morphologic information derived from CMR appears theoretically to be helpful in defining the nature and severity of myocardial involvement at presentation, as well as during follow-up of patients with cardiac contusion.