Unrecognized abdominal injuries may lead to preventable trauma deaths. These deaths are due to exsanguination in the immediate posttraumatic period or secondary to septic complications which arise later. Diagnosis of intra-abdominal injuries in blunt trauma can be difficult because of associated head injuries, altered mental status from drugs and/or alcohol or other more spectacular, but less life-threatening, injuries. This video presents an organized approach to the blunt trauma patient and is intended to help minimize the risk of overlooking intra-abdominal injuries. It examines Emergency Department resuscitation and evaluation, intraoperative care, and postoperative critical care management of blunt abdominal trauma.