Pelvic fractures caused by high energy trauma such as falling from a height or road traffic collisions have a high mortality rate and many patients are left with life changing and debilitating injuries. High energy fractures to the pelvis can be associated with major haemorrhage and injuries to internal organs in the pelvis [Vaidya et al 2016]. Emergency nurses have a fundamental role in caring for these patients and the nurse assessment and management of the patient in the acute phase is important to improve the patient's overall outcome. This article focuses on the anatomy of the pelvis, initial assessment and management of patients presenting with high-energy pelvic fractures and complications associated with pelvic fractures.