This article reviews the current state of the art for use of computed tomography (CT) in adult patients with blunt abdominal trauma, with emphasis on helical CT. It reviews the optimal helical CT technique in these patients and discusses the clinical presentation and CT findings of traumatic injury to organs of the peritoneal and retroperitoneal spaces. Throughout the article, references are made to alternative diagnostic techniques. The concluding section discusses the use of ultrasound (US) and the relative roles of helical CT and US in acutely traumatized patients.