Traumatic hemorrhage is a major cause of mortality and morbidity worldwide; at the same time, it has been an excellent model to gain fundamental insights into the pathophysiological principles of the management of critical hemorrhage. In this chapter, we will review the pathophysiological basis of traumatic coagulopathy, including its interactions with the mechanisms regulating inflammation and the immune response. We will then critically analyze laboratory methods useful for monitoring its progression. Finally, we will present the treatment strategies recommended by current guidelines, with particular attention to assessing the quality of the available evidence for each of them.