GU trauma can easily be missed when associated with other abdominal/pelvic injuries. The type/mechanism of the trauma is the key for both imaging and treatment. Iatrogenic injuries of the GU tract are getting more and more common as a result of increasing numbers of percutaneous procedures (e.g. nephrolithotomies, biopsies). In general, renals are the most common injured part of the tract; however, by increasing numbers of renal transplantation, ureteral injuries are now common as well. Timing of the intervention is as important as taking the decision of percutaneous approach for optimal management of injury. Multiphasic CT imaging with contrast injection via both IV line and trans-urethral catheter (if possible) can demonstrate most of the injured sites with high sensitivity. CT is also useful in predicting which haemodynamically stable patients may benefit from percutaneous (non-operative) management. Vascular injury of the GU tract almost always involves renals, and bleeding and/or ischaemia is the problem. Unless the patient is at unresponsive haemodynamic shock, or has complete vascular avulsion, endovascular treatment may always be the choice. The American Association for the Surgery of Trauma system for grading injury to the kidney is also helpful in making a decision whether surgical or endovascular intervention is used. Embolisation of a bleeding artery/ pseudoaneurysm or stenting of an intimal dissection are the most common cases.