Blunt and penetrating abdominal trauma present a clinical challenge, particularly in the context of multiple other injuries, due to their relative infrequency, diagnostic uncertainties, and deleterious consequences if not treated promptly. Small bowel or stomach injury is frequently diagnosed when accompanying intra-abdominal injuries are present. Although isolated injuries are uncommon, paying close attention to the cause of the injury, performing an abdominal exam, having hematuria, and having a severe base deficit should raise the probability of these injuries. Surgical management of small bowel and stomach injuries is the preferred option in trauma setting. Rapid access to all areas of the abdominal cavity is made possible by the adaptable trauma laparotomy approach. The current standard of care for isolated small bowel injuries is primary anastomosis in patients receiving definitive laparotomy or delayed anastomosis in patients needing damage control surgery. This chapter discusses the evaluation, diagnosis, treatment, and review of recent literature to develop recommendations for the routine diagnosis.