The need for prospective studies in trauma radiology emerges as knowledge on the appropriate use of imaging becomes increasingly important in this field. Prospective observational studies enroll patients after research questions are articulated but only observe medical practice and should not compromise or change patient treatment. However, controversy exists regarding the requirement of informed consent from trauma patients in this type of study. This is reflected not only in differences in reporting informed consent in recent scientific publications on trauma radiology but also by the fact that policies regarding this topic vary in different parts of the world. The authors consider whether requesting informed consent is appropriate in prospective observational studies in trauma radiology from practical and different ethical perspectives.