Management of the patient with hypovolaemic shock remains a difficult challenge, especially when hypovolaemia is associated with severe trauma. The mortality and morbidity among these critically ill and often young patients can be reduced significantly by optimal management. This should include rapid surgical control of the bleeding source, early detection and correction of tissue hypoxia by increasing oxygen delivery and consumption, and attenuation of the traumatic neural response and inflammatory reaction by adequate analgesia and early operative repair.