Compulsion of pre-hospital trauma care are dictated by the fact that every year in India over 3 lakhs people die of trauma and out of these 50,000 dies on the road. 18 per cent of patients died unnecessary during pre-hospital transportation. These patients either exsanguate, had airway obstruction or ventilatory compromise, which could have been rapidly treated in the field before or during transportation. Immediate deaths (50%) cannot be salvaged by any treatment but these can be prevented by improved crash worthiness of motor vehicle, compulsory use of crash helmet and safety belt. The aim of pre-hospital care is to prevent early deaths (30%) and sustain life till the patient reaches hospital where definite treatment can be provided. Features of pre-hospital phase: extrication of casualty and protection of cervical spine, airway control, control of hemorrhage, venous access and intravenous fluids, treatment of cardiac arrest, sucking chest wound, cardiac tamponade, tension pneumothorax, evisceration of viscera, splinting of fractures, administration of analgesics, antibiotics, tetanus prophylaxis. Recommended triage scheme involves a 4 step evaluation process .Impaired vital signs and GCS, evaluation of critical injury pattern, assessment of high energy impact mechanism and assessment of special patient considerations: extremes of age, pregnancy. Anticoagulation, burns and end stage renal disease.