This is a retrospective study of 57 patients with gunshot injuries of the abdominal aorta. The aortic repair was achieved by various means: lateral aortorraphy, patch aortoplasty and graft insertion. There was an 85 per cent mortality rate from bleeding or secondary coagulopathy directly related to the aortic injuries. The need for resuscitative thoracotomy, shock, lack of response to fluid resuscitation and intraperitoneal bleeding were directly related to mortality. We feel that shortening of prehospital transfer time will increase the absolute number of patients surviving this grave injury.