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Traumatic pneumothorax (TP) is considered a prevalent pathology involved in chest trauma. Higher the number of accompanying pathologies, higher the rates of prolonged length of hospital stays and mortality. This study aimed to investigate the effect of accompanying pathologies on mortality in patients with TP. This study followed a single-center retrospective design. Patients with trauma who were diagnosed with pneumothorax in a tertiary emergency department in Turkey between January 1, 2022 and December 31, 2023, were included in the study. Logistic regression analysis was used to investigate the factors affecting mortality. During the study period, 252 patients were diagnosed with TP. The median age of these patients was 56 years, and the median length of hospital stay was 4 days. The most prevalent accompanying pathologies in patients with TP included rib fracture, hemothorax, and fracture of any of the extremities. The most prevalent pathologies associated with mortality were hemothorax, lung contusion, lower extremity fracture, traumatic brain injury and abdominal injury (P = .007, P = .036, P = .027, P = .005, and P = .002, respectively). Accompanying pathologies associated with an increased risk of mortality included bilateral pneumothorax, traumatic brain injury and abdominal injury (P < .001, P = .035, and P = .001, respectively). TP is considered one of the most prevalent chest traumas that can cause mortality. While accompanying pathologies such as hemothorax, lung contusion, and lower extremity fractures are associated with higher mortality in univariate analyses, they do not independently predict death. The independent predictors that substantially increase the risk of mortality in patients with TP are bilateral pneumothorax, traumatic brain injury, and abdominal injury.