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To review the clinical presentation, diagnosis, and management of injury to the abdominal aorta after blunt force trauma. This study was a retrospective review. A total of 5,676 patients were admitted to the University of Michigan Medical Center with traumatic injury. Seven had injuries to the abdominal aorta after a blunt force mechanism. Five patients had operative repair of the aortic injury, of which four involved orthotopic graft placement and one had an extra-anatomic bypass. Two patients had the aortic injury repaired by endovascular stent placement in the angiography suite. One patient died, and lower extremity amputations were performed in three patients. Surgical repair of abdominal aortic injury is preferable for the unstable patient or those with threatened extremities. In the stable patient with viable limbs, treatment with radiologic placement of endovascular stents may provide a nonoperative option for management.