Patient survival after the development of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) has improved significantly over the past two decades through improved diagnosis and multidisciplinary management. Published mortality rates approaching 100 per cent have been replaced by mortality rates of 20 to 50 per cent depending on age and mechanism of injury. Simultaneously, same-admission definitive abdominal closure rates of almost 90 per cent have been reported by several centers. The seemingly aggressive management techniques required to achieve this success have been shown to be associated with excellent long-term physical and mental health outcome. Appropriate management of the patient with IAH/ACS is associated with both significantly improved patient survival and decreased resource use. These improvements are easily achievable by virtually any hospital through adoption of a multidisciplinary IAH/ACS management protocol.