“Blind puncture” of the subclavian and jugular veins to obtain central venous access used to be standard practice. However, subclavian vein puncture is not without complications. As the subclavian vein passes inferiorly, posterior to the clavicle, it passes over the apex of the lung. Any misplacement of a needle into or through this structure may puncture the apical pleura, producing a pneumothorax. Inadvertent arterial puncture and vein laceration may also produce a hemopneumothorax.