Introduction: Paralytic ileus posttraumatic is the beginning of a chain of deep systemic pathological disorders of the body, complicating and worsening the results of treatment in patients. Early posttraumatic intestinal paresis is considered a pathognomonic symptom of retroperitoneal hematoma, in addition, gastrointestinal motility may be a complication of postoperative laparotomy. The problem of prevention and treatment of intestinal paresis remains unresolved and relevant. Aim: Identify an effective complex measure in posttraumatic intestinal paresis. Materials and methods: Study of 195 patients with trauma, complicated by intestinal paresis. It were 140 (71,79%) men, 55 (28,2%) women. Mean age 39,45 ±16,29 years. Causes of injury: road accidents109(55,89%), katatrauma-59(30,25%), crushed11(5,64%), direct blows- 8(4,1%), etc.- 8(4,1%) cases. Conduct surgical algorithm was applied according to established tactics in Surgery Clinic N1. Results: Intestinal paresis was found in 66 patients. Of these 30(28,84%) patients with severe intestinal paresis required ample treatment. Causes complications in this group of 30 patients, when the intestinal paresis directly or indirectly influence disease outcome: septic33,33% (10), MODS- 21,73% (5); in 60,89% (14) of cases patients died. Mortality was 36,92% (72) cases. Conclusions: Management of posttraumatic intestinal paresis must be complex, especially to act at all stages of pathogenesis, which will reduce the development of severe infectious complications, increase the efficiency of treatment and reduce mortality.