Abdominal trauma remains a leading cause of mortality in all age groups. Blunt abdominal injury (BAI) is common and usually results from motor vehicle collisions (MVC), falls and assaults. In children (less than or equal to 14 years of age), blunt abdominal trauma is the second most frequent cause of mortality preceded by head injuries. Injuries in the abdomen occur from direct forces causing compression or shearing type injuries or deceleration injuries that result in damage to relatively fixed structures. The most common organ injured is the spleen, followed by the liver and small bowel. The evaluation of the abdomen is very challenging and can often result in missed intraabdominal injury or overuse of diagnostic imaging such as computed tomography (CT). A systematic approach should be taken when assessing the trauma patient. This systematic approach should include the Primary and Secondary Survey with considerations for possible intraabdominal injury.