The incidence of severe injury range from 30 to 52 per 100,000 per yr, with about 90% due to blunt trauma. Parts of Scandinavia are sparsely populated and with long prehospital distances. In accordance with other European countries, prehospital physicians are widely employed and studies indicate consequent survival benefits in trauma patients. More than 200 Scandinavian hospitals receive injured patients, increasingly with multidisciplinary trauma teams. Challenges remain in the prehospital identification of the severely injured. Improved triage allows for better match between patient needs and level of resources made available. Trauma management is threatened by the increasing sub-specialization of professions and institutions. Scandinavian research is leading the development of team- and stimulation-based trauma training. Several pan-Scandinavian co-efforts have facilitated research and provided guidelines for clinical management.