Vascular injury is a potential complication of central venous catheter (CVC) insertion, often used for dialysis or other procedures, superior vena cava and /or Azygos Veins injuries are a rare but serious complication that can occurs when inadvertent cannulation during this procedures, and damage these vessels. This can lead to significant bleeding and potentially life-threatening complications. Prompt recognition and management are crucial. Here we report such an inadvertent central venous injury requiring thoracotomy following haemodialysis catheter placement along with review of literature and recommendation to prevent such complication.