Pectoralis major injuries typically occur in active individuals participating in manual labour or sports. While these injuries are rarely reported, the actual incidence of pectoralis tears among all shoulder injuries is unknown. Diagnosis can usually be made based on a patient's history and physical examination. However, ultrasound and magnetic resonance imaging are helpful tools for diagnosis and pre-operative planning. Specific treatment options should be based on the severity of the injury and the patient's individual needs. Nonoperative management consisting of immobilisation and physical therapy can offer a functional result with return of shoulder motion and activities of daily living. In recent studies, operative repair of pectoralis major rupture has been shown to restore normal chest-wall muscle contours and pre-operative strength (even in competitive athletes). Although complications such as re-rupture, infection, and heterotopic ossification do occasionally occur, favourable results should be expected when surgical repair is performed either acutely or in a delayed fashion.