- Emergency laparotomy in trauma patients can be part of the resuscitation process, is based on damage control principles and is therefore fundamentally different from elective laparotomy, for example in case of malignancies. - Indications for emergency laparotomy after trauma are based on haemodynamic instability of the patient and the procedure is focused on restoring the patient's physiological condition.- Haemodynamic and biochemical parameters are used to determine the rest of the strategy. In order to optimize the procedure, the entire treatment team should be practiced in this.- Fewer and fewer surgeons are carrying out general laparotomies and even fewer are carrying out emergency laparotomies after trauma.- Knowledge and skills about emergency laparotomy after trauma are at risk of disappearing because of this, not only for surgeons but also for other team members.- Increased centralisation, team training, more cooperation and consultation for specific indications may all contribute to expertise preservation.