Genitourinary trauma occurs in about 10–20% of multiply injured patients and occurs in conjunction with other life-threatening injuries that require immediate attention. Initial assessment should include securing the airway, controlling external bleeding and resuscitation of shock. In many cases the patient is attended by a team where examination and resuscitation is carried out simultaneously. Recognition of genitourinary trauma with appropriate investigations is necessary to select patients for immediate intervention or conservative measures. We discuss the assessment and management of these patients.