Blunt abdominal trauma in childhood is a common clinical occurrence. Accurate assessment requires an understanding of patterns of injury and the response of the child. Repetitive examinations in a comforting environment will yield superior clinical judgment. Renal trauma is frequent, requires thorough radiologic evaluation, and may be associated with an underlying anomaly. The goal of management is salvage of functioning nephrons. Definitive indications should exist prior to operative intervention. The goal of management of splenic injury should not be the justification of splenectomy. The operative decision should be based on clinical indications. Judgment should include a knowledge of the risks and alternatives.