AIM OF THE STUDY: To evaluate our experience in the treatment of complex abdominal injuries with the principles of Damage Control Surgery (DCS). METHOD: A retrospective review was conducted of 55 patients with multiple abdominal injuries and severe haemorrhage induced hypothermia and acidosis admitted to the «Ospedale Maggiore Trauma Center» in Bologna from 1989 to June 2005. RESULTS: All the patients but one had major blunt trauma. Mean age was 40.1; mean ISS 42; mean RTS 4.11; extimated loss of blood was greater than 4000 ml. Packing provide definitive control of bleeding in 44 patients but 10 had recurrent bleeding or bleeding from different injuries such as bone fractures and required further surgery (2) or arterial embolization (8). Twenty eights patients (50.9%) died.Survival was strongly associated with the ISS, GCS, the loss of blood and acidosis. CONCLUSION: The Authors concluded that in selected circumstances the traditional approach to severe abdominal injuries is not appropiate. In this situation, alternative and aggressive treatment such as the Damage Control Surgery has been recommended as the procedure of choice.