Background: Abdomen is one of the most important regions in the human body containing organs that all of them can be exposed to penetrating injuries. Evaluation of the abdoman traumatic injuries among war casualties, and treatments performed for them enable us to improve the quality of care for war victims.

Materials and Methods: In this retrospective study, 1176 medical records of Iranian casualties during the imposed Iraq-Iran war with penetrating abdominal injuries undergoing laparotomy were enrolled to the study.

Results: Among 1176 medical records, 3574 cases of abdominal injuries were registered and 1440 surgical operations were performed. Frequency of the most prevalent injuries were as follows: small intestine (412, 11.5%), colon (260, 7.2%), spleen (139, 3.8%), diaphragm (119, 3.3%), stomach (118, 3.3%), and liver (110, 3%), respectively.

Conclusion: Colon and small intestine injuries are important for surgeons in field hospitals. In addition, applying standard protocol for surgery in war is effective.