Thirty-two of 320 patients with severe thoracic trauma were treated with costal stapling. The technique, described by R. Judet in 1973, is basically simple but sometimes difficult to perform. In the most favourable cases (here 23/32 patients), it avoids tracheostomy and its complications and reduces the restrictive sequelae associated with pleural adhesion or thoracic wall deformities. In addition, active respiratory physiotherapy can be undertaken at an earlier stage. The authors describe the indications and limitations of this treatment on the basis of the results obtained in this series.