Introduction. Penetrating abdominal trauma (PAT) is still a serious problem all over the world. Routine laparotomies has been preferred in patients with PAT with evisceration for a long time. New treatment algorithms have been sought due to the high rates of unnecessary laparotomies which make up to ½ cases, complication rates that range between 2.5-41% and high morbidity rates reported in various studies. Aim of the study. To compare the efficiency of laparotomy and Selective Nonoperative Management (SNM) in this kind of trauma in the Republic of Moldova. Materials and methods. In our study 61 patients with PAT with evisceration treated at the Emergency Medicine Institute during 2006-2011 were analyzed. We collected data from the patients’ medical records regarding: sex, age, geographic distribution of the patients, mechanism, rate of non-therapeutic laparotomies, complications.Results. 47.54% of the patients were over 30 years. 95.08% of the patients were men. 65.57% of the patients live in Chisinau (urban medium). Most traumatic injuries were produced by stab wounds (95.08%). 65.57% of patients had omental evisceration, small intestine in 29.52%, colon in 4.91%. Haemodynamically unstable patients with peritonitis (64.0%) prevailed over the stable ones (36.0%). 9 patients (14.75) of those who were stable were treated with SNM, including 4(6.55%) cases of failed approach, 5(8.19%) patients were successfully managed and other 13(21.31%) patients underwent laparotomy with complication in 7 cases (11.47%). Twenty-nine patients (47.54%) hadn’t any major intra-abdominal injury. Patients successfully managed by SNM (5 cases) had significantly shorter hospital stay than those who underwent non-therapeutic laparotomy (13 patients). Average hospital stay for patients treated by SNM are in 80% was less than 3 days and for patients with laparotomy in 69.23% less than 9days. Conclusions. This study has demonstrated better efficiency of SNM for the stable patients that a significantly less complication rate than patients treated operatively and a shorter hospital stay. SNM is necessary to minimize preventable morbidity and mortality for the stable patients. Although the rate of nontherapeutic laparotomies after penetrating wounds to the abdomen should be minimized, this should never be at the expense of a delay in the diagnosis and treatment of injury.