Introduction: Traumatic hemothorax is a common consequence of chest injuries, affecting approximately 60% of trauma patients. This study explores the outcomes of two management approaches: tube thoracostomy alone and tube thoracostomy followed by mini-thoracotomy. Methods: This prospective pilot study, conducted at a tertiary teaching hospital, enrolled 55 patients with traumatic hemothorax, dividing them into two groups. Group 1 underwent tube thoracostomy alone, while Group 2 received additional mini-thoracotomy. Outcome measures included duration of chest tube insertion, hospital stay, and long-term complications such as empyema and fibrothorax. Results: The study revealed no significant differences between the two groups in terms of age, gender, mechanism of injury, and type of injury. However, Group 2 showed a significantly longer hospital stay and chest tube duration. Complications such as surgical site infections and empyema were more prevalent in Group 1, while pain was higher in Group 2. Conclusion: Combining mini-thoracotomy with tube thoracostomy for traumatic hemothorax management demonstrated superior long-term outcomes, including reduced complications. Despite a prolonged chest tube duration and hospital stay in the mini-thoracotomy group, the benefits in terms of improved quality of life and reduced treatment costs justify its consideration. Further studies with larger sample sizes and longer durations are recommended to validate these findings