Even though trauma surgeries are often emergent, teamwork and operative planning are still the keys to success. Preparing for trauma surgery includes considering the prioritization of the injuries, unique physiologic needs of the patient, and available resources including equipment and personnel. Once in the operating room (OR), a systematic approach to preparing the patient and looking for injuries can ensure an efficient surgery and that no major injuries are missed. Finally, unlike most other specialties, sometimes the best operation is one that temporizes an injury and provides time for resuscitation, ultimately deferring definitive repair for another time.