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Most practicing anesthesiologists are involved in the care of multisystem injured patients at some time in their careers; others specialize in trauma management. In addition to providing anesthesia for trauma patients requiring surgery, anesthetic training and skills naturally lend themselves to the ongoing monitoring, resuscitation, and critical care that these challenging patients require. An understanding of the mechanisms of injury and the resultant patterns of injury is essential for the management of every traumatized patient. This knowledge allows clinicians to formulate perioperative management plans that optimize safety for patients and to anticipate complications that may arise later from missed or occult injuries. As an integral part of the team caring for these complex patients, it is unacceptable for anesthesiologists to merely provide intraoperative anesthetic care in isolation. This article discusses those mechanisms of injury in commonly seen types of blunt and penetrating trauma and reviews the patterns of injury resulting from them.