1. To become familiar with the most important imaging features and their impact on patient management. 2. To understand technical details, potential difficulties and pitfalls of demonstrating these findings. 3. To be familiar with the pertinent findings to report. Thoraco-abdominal injuries are a significant cause of death in the polytraumatised patients. Early recognition and communication of life-threatening thoraco-abdominal injuries is the major task for the radiologists involved in the emergency room. Although, most of these patients reach the hospital prior to death, lethality continues to remain high. Heart, thoracic great vessels, trachea, bronchus, pleura, lung, diaphragm, abdominal/retroperitoneal vascular and solid organ injuries are potential causes of death. Any appropriate surgical/interventional management approach must be carried out "around the clock", before the thoraco-abdominal injuries reach the level of clinical evidence. On the other hand, non operative management has actually become the standard of care for the most serious thoraco-abdominal injuries. These goals become feasible if a correct contrast-enhanced MDCT diagnosis, in a dedicated facility in which the trauma team works effectively 24 hours a day, seven days a week, is performed. Thus, in this lecture, the most serious thoraco-abdominal injuries will be illustrated, with special emphasis on vascular injuries as well as the value of post-processing techniques, protocols, pitfalls, tips and tricks. Furthermore, the importance of a rational and integrated imaging approach will be pointed out and, finally, the role of the radiologist in emergency room will be emphasised. Learning Objectives: