Background: Accidental catheter removal or drain dislodgment, including tube thoracostomy, is a common, high-risk complication in hospitalized and ambulatory patients that often necessitates an additional procedure, increased length of stay, and increased cost. Methods: The aim of this study was to compare the tensile strength of pigtail catheter fixation using a simple interrupted suture, a U-stitch suture, or 2 simple interrupted skin sutures in a standardized skin model. Catheters were sutured to the skin, penetrating the collagen layer, with 1 of the 3 suture techniques and varying suture combinations. Results: For each trial, breakage occurred at the suture or knot. The mean breakpoint varied significantly between 2 simple interrupted sutures and both the 1 simple interrupted suture and the U-stitch technique (analysis of variance post hoc test P < .001), with the 2 simple interrupted suture technique withholding nearly 40% more force. Using the strongest suture, 0 silk, on a deceased adult sheep to secure a pigtail thoracostomy catheter yielded identical data compared with the standardized skin model. Conclusions: In conclusion, 2 simple interrupted skin sutures to secure a pigtail catheter has very low risk with a strongly positive benefit.