Patients suffering from a traumatic injury are often evaluated in a systematic fashion by a multidisciplinary team of specialists including pharmacists. The Advanced Trauma Life Support guidelines provide a framework of how these patients should be managed. Pharmacists on the trauma teams and involved with the care of the critically ill trauma patient must be knowledgeable about the pharmacotherapy of trauma. Trauma patients in the acute setting may require medications for intubation, sedation, analgesia, antibiotics, adjuncts to resuscitation, anticoagulation reversal, and more. After the initial insult, pharmacists optimize care as it relates to venous thromboembolism prophylaxis and unique trauma-related sequelae that are complicated from the initial injury. The emergency medicine and critical care pharmacist play a vital role in the management of this patient population.