Combat-related injuries have been well documented for centuries. More recently, injuries suffered by US service members in Iraq and Afghanistan have resulted in a high number of survivable conditions. Polytrauma care in this setting must take into account both the physical and psychological injuries suffered by returning wounded warriors. Catastrophizing may occur when previously healthy individuals are faced with impairment and disfigurement. This is compounded with repeated operative procedures. Early detection and treatment of catastrophizing contributes to improved care of the wounded warrior. This article describes our experiences at Walter Reed Army Medical Center with catastrophizing in US service members returning from the current military operations in Iraq and Afghanistan.