Rectal injuries can be caused by blunt or penetrating trauma. Most rectal injuries are associated with other injuries including pelvic fractures as well as major vascular, solid organ, and/or other bowel injuries. Computed tomography (CT) scan with intravenous (IV) and rectal contrast is the best diagnostic modality for rectal injuries. Management of rectal injuries is variable depending on the location of the injury, grading, and its extension into the peritoneum.