Background: Impalement injuries are a rare occurrence. Although most cases that have been reported involve the torso, not much has been studied about upper limb injuries. Hence reporting a case of impalement injury to the upper limb and its management holds value in rapid early intervention and future treatment protocols. Case Report: A 38-year male with history of fall from height presented with impalement injury from spearhead iron fence to left forearm which entered through the ulnar aspect not extruding through the radial side. The patient was taken for emergency exploration under general anesthesia and the impaled iron fence rod safely removed after confirming the integrity of the ulnar neurovascular structure. The injured muscles were repaired, and the patient had an uneventful post-operative outcome. Conclusion: Thus, an early active surgical intervention under anesthesia is safe with reduced risk of post-operative complications like infection and loss of hand function.