On April 21, 1945, Lt. Inouye was grievously wounded while leading an assault on a heavily defended ridge near San Terenzo in Liguria, Italy, called the Colle Musatello. The ridge served as a strongpoint of the German fortifications known as the Gothic Line, the last and most unyielding line of German defensive works in Italy. As he led his platoon in a flanking maneuver, three German machine guns opened fire from covered positions 40 yards away, pinning his men to the ground. Inouye stood up to attack and was shot in the stomach. Ignoring his wound, he proceeded to attack and destroy the first machine gun nest with hand grenades and his Thompson submachine gun. When informed of the severity of his wound, he refused treatment and rallied his men for an attack on the second machine gun position, which he successfully destroyed before collapsing from blood loss.