Following plain radiographic examination CT with multiplanar reformatting (CT/MPR) was used to assess 34 patients with pelvic trauma and definite (24 patients) or clinically suspected (10 patients) fractures. Computed tomography/MPR detected four fractures missed on conventional radiography. The findings on CT/MPR led to major alterations of patient management in seven cases. In four patients in whom the initial decision had been to use closed management with traction, information derived from CT/MPR led to open surgical reduction. In three patients in whom the initial impression had been that open management was dictated, CT/MPR contributed anatomical information that reserved that decision, leading to more conservative management. In all patients going to surgery the surgeons believed that surgical planning and execution had been significantly affected by the information provided by CT/MPR. Computed tomography/MPR was used postoperatively in 10 patients to confirm the status of reduction and fixation and to evaluate patients with unusual problems in the recovery period.