Abstract: A combination punching and setting tool and method includes an elongate body with an upper impact end, a lower attachment end, and at least one interchangeable tip interchangeably received on the attachment end. The interchangeable tip is selected from the group consisting of i) a punching tip configured to punch an opening in a base material, and ii) a setting tip configured to set a securing device placed in an opening in the base material. The elongate body includes an ejection chute for ejecting base material punched by the punching tip out of the elongate body. The setting tip may include a pattern, formed on a lower end of the tip, configured to form a corresponding pattern on the securing device when the securing device is set.