The evaluation and care of the pregnant trauma patient follow the same principles as those of the nonpregnant trauma patient, with some important distinctions. First, epidemiology and patterns of injury differ slightly between pregnant and nonpregnant patients. Second, physiologic changes in pregnancy require consideration during the resuscitation of a pregnant trauma patient. Third, injuries specific to pregnancy (e.g., placental abruption, uterine rupture, fetal injury, etc.) need to be identified in addition to other injuries. Finally, adjunctive therapies specific to pregnancy (e.g., administration of Rho (D) immune globulin or betamethasone) should be considered during resuscitation. It is essential to remember that fetal outcomes are optimized by providing the best possible care for the pregnant patient. Standard ATLS protocol should be observed in the care of pregnant patients, and necessary imaging should neither be avoided nor delayed due to concern for fetal radiation exposure.