Though duodenum is a retroperitoneal structure well protected as compared to other intra-abdominal organs, blunt injuries are relatively fairly common. Duodenal trauma occurs following blunt injuries or penetrating injuries. Blunt injuries are common in road traffic accidents; impact with a steering wheel, faulty seat belt and bludgeoning assault during fights or rural bull injuries. Penetrating injuries are mostly due to gun-shot wounds or stab injuries. The majority of patients will complain of acute abdominal and back pain, which on occasions radiates to the right iliac fossa. Initial signs are diffuse tenderness and decrease bowel sounds. In matters of few hours depending on size and site of perforation, guarding and rigidity will be present. Computed tomography (CT) of the abdomen is becoming the initial investigation of choice due to its capacity to demonstrate retroperitoneal structures. Diagnostic peritoneal lavage is often negative. Injuries are graded as intramural hematoma (Grades I and II); Lacerations: grades I, II and selected III; lacerations: Grades III, IV and V. Management of these injuries is surgery. A large bulging intramural hematoma when encountered, the hematoma should be evacuated. Patients who remain obstructed following an initial attempt at simple evacuation of the haematoma, gastrojejunostomy with vagotomy is the treatment of choice. Blunt injuries without major loss of duodenal wall or viability, perforations from stab wounds, circumscribed injuries from low velocity gun-shot wounds that do not involve pancreas are dealt with primary closure and closed suction drainage. Management of grade grades IV and V injuries entails procedures to protect the repair from dehiscence as this complication at or distal to ampulla of Vater carried mortality in excess of 50%. Options are: end to end gastroduodenostomy, end to end duodenojejunostomy, jejunal patch/serosal jejunal onlay, side to side duodenojejunostomy Roux-en-Y, duodenal diverticulisation, pyloric exclusion distal pancreatectomy with one of the above, pancreatoduodenectomy.