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Traumatic hemipelvectomy is a life threatening, however rare injury associated with high lethality. It comes along with excessive blood loss, related hemodynamic instability and injuries of the genitor-urinary system or the rectum. The real incidence is unknown because most patients die before reaching the hospital. The treatment requires a rapid, multidisciplinary team approach focused on hemorrhage control to correct coagulopathy and clear persistent signs of tissue hypoperfusion to save the patient’s life [1]. Improvements in prehospital rescue systems and initial trauma response have resulted in increased chances of survival. Most survivors are young, healthy individuals, who are able to tolerate massive hemorrhage and soft-tissue destruction [2-6]. We present a case of an open fracture of the ileosacral joint, wide open symphysis, complete hemipelvectomy and severe soft tissue trauma, including a decollement around the pelvis and the left abdomen.