A 33-year-old man was admitted to hospital with a butter knife stuck in his head after having attempted to commit suicide by forcing the knife through his skull. Physical examination revealed a stable patient with only minimal associated haemorrhage. A CT scan revealed, that the penetrating knife had passed through the sphenoid bone, the posterior orbit and the ethmoid cells and ended in the contralateral nasal cavity. The knife was removed by its own trajectory. After surgery, the patient was neurologically intact with normal sight and well-functioning eye movements, and he made a full recovery.