Abdominal trauma represents a significant cause of morbidity and mortality in trauma patients. It is classified as either blunt or penetrating, with different mechanisms of injury and management approaches for each. Blunt abdominal trauma typically results from motor vehicle collisions, falls, assaults, or sports injuries, while penetrating trauma is caused by stab wounds, gunshot wounds, or impalement injuries. The abdomen is anatomically divided into three zones: the peritoneal cavity, the retroperitoneum, and the pelvis. The peritoneal cavity contains the liver, spleen, stomach, small bowel, most of the colon, and in females, the uterus and ovaries. The retroperitoneum houses the kidneys, pancreas, duodenum, ascending and descending colon, major vessels (aorta and inferior vena cava), and portions of the urinary tract. The pelvis contains the rectum, bladder, and in females, the internal reproductive organs. Abdominal injuries can be challenging to diagnose, particularly in blunt trauma, as signs and symptoms may be subtle or masked by other injuries. A high index of suspicion is essential, especially in patients with significant mechanisms of injury, altered mental status, or distracting injuries. Missed abdominal injuries are a common cause of preventable death in trauma patients. Clinical Scenario: A 35-year-old male presents after a high-speed motor vehicle collision. He complains of abdominal pain and has bruising across his lower abdomen from the seatbelt. His vital signs show tachycardia (HR 110) and borderline hypotension (BP 100/60). This presentation should raise immediate concern for potential intra-abdominal injury requiring prompt evaluation and management.