Successful management of abdominal trauma is characterized by efficient emergency-room work-up aimed at immediate determination of the prognosis by rational use of diagnostic techniques. The purposes of any conservative and/or surgical procedures are the preservation of organ function and low mortality and morbidity in multiply injured patients. State-of-the-art computed tomography with fast trauma scanning has become well accepted among patients with multiple trauma. Organ resections are becoming less common, except in the case of bowel injuries. The surgical treatment of hepatobiliary, splenic and large-vessel trauma is still challenging, as it involves the risk of life-threatening bleeding, while in the case of pancreatic and bowel injuries the challenge lies in the avoidance of septic complications. Interdisciplinary management of complex injuries with application of the "damage control" concept contributes to high-quality results in abdominal trauma.