Damage control is a new term first used by the United States Navy during World War II to describe emergency measures for control of flooding that threatens to sink a ship. Central goal is to ensure survival of the ship until it reaches a port where definitive repairs can be safely performed. The term “Damage control” was introduced by Rotondo and Schwab in 1992 and outlined a three phased approach: a) Part one (DC-I) consists of immediate exploratory laparotomy with control of bleeding and contamination, abdominal packing and abbreviated wound closure; b) Part two (DC-II) consists of the ICU resuscitation; immediate endpoints include physiological and biochemical stabilization. A tertiary exam should be performed at this time to identify all injuries; c) Part three (DC-III) consists of re-exploration and definitive repair of all injuries. Coagulopathy observed in trauma patients was thought to be a resuscitationassociated phenomenon. The replacement of lost and consumed coagulation factors was the mainstay in the resuscitation of hemorrhagic shock for many decades. Recently, better understanding of the pathophysiology of coagulopathy in trauma patients has led to the logical opinion that we should directly address this coagulopathy during major trauma resuscitation. Damage control resuscitation (DCR), the strategic approach to the trauma patient who presents in extremis, consists of balanced resuscitation, haemostatic resuscitation, and prevention of acidosis, hypothermia, and hypocalcemia. The term “lethal triad” was used to describe the physiologic derangement observed in these patients and refers to the triad of the deteriorating status of acute coagulopathy, hypothermia, and acidosis of exsanguinating trauma patients. Recently, injury itself is reported to cause early coagulopathy, which is known as “traumainduced coagulopathy” or “acute traumatic coagulopathy (ATC). ATC is an obvious early coagulopathy and occurs prior to significant dilution, within 30 min of injury, and affects a quarter of the patients with severe trauma. The patients with this coagulopathy have higher mortality than those with normal clotting function. Damage control surgery is defined as the planned temporary sacrifice of normal anatomy to preserve the vital physiology. This is a concept in which the initial surgery becomes part of the resuscitation process rather than part of the curative process. It consists of 3 parts including the initial abbreviated laparotomy, ICU resuscitation and subsequent reoperation for definitive resuscitation. Damage control surgery is a surgical strategy aimed at restoring normal physiology rather than anatomical integrity. Only when the patient has become physiologically stable is the final therapeutic surgery embarked on. This process serves to limit the physiological exposure to an unstable environment, allowing better resuscitation and outcome in the critically ill trauma patients. Conclusions: Damage Control Resuscitation represents the most important advance in trauma care. DCR strategy is the measure that directly addresses trauma-induced coagulopathy. Although several concerns, such as the plasma to RBCs ratio, the method of achieving balanced resuscitation, and the administration of other coagulation factors it is now the most beneficial measure for treating trauma-induced coagulopathy, and it can change the treatment strategy of trauma patients. The effect of the reversal of coagulopathy in the massively hemorrhagic patient may shift the operative strategy from one of DCS to definitive surgery. Damage control philosophy is based on the principal that outcome after major trauma is determined by the physiological limits of the patient, rather than by the effort of anatomical restoration by the surgeon.