The incidences of both trauma and obesity are rapidly on the rise. Whilst dedicated trauma centres exist, these may not be equipped to manage obese and super-obese patients' unique medical and surgical demands. This review assesses the impact of trauma on the obese patient and the specialist considerations required in their management throughout pre-hospital, acute and inpatient phases of trauma care. Specific recommendations for the necessary infrastructure and equipment are made to ensure optimal care of the obese trauma patient. We also review evidence-based best practice in the assessment, diagnosis and treatment of this patient group. Only by addressing the unique needs of obese trauma patients with specialist education, equipment and infrastructure can optimal patient outcomes be assured.