Traumatic injuries complicate approximately 1 in 15 pregnancies and are the leading cause of non-obstetric death in pregnancy, with a significant proportion due to interpersonal violence. Injury during pregnancy is associated with an increased risk of adverse obstetrical outcomes. Pregnancy induces certain physiologic changes that in turn create important alterations in clinical presentation that must be recognized and responded to. While maternal resuscitation is always paramount, the presence of a viable fetus and the potential for pregnancy-specific injuries create important challenges in the management of pregnant patients and require integrated multidisciplinary teams to provide optimal care.