Background: Although, selective nonoperative management of penetrating pelvic injuries is a feasible, safe and effective alternative; lack of advanced imaging studies in developing countries to assess these patients, force us to perform more invasive procedures to treat them. Study design: Cases analysis performing with patients with penetrating pelvic trauma underwent to laparotomy in General Hospital of Juarez City (Mexico), during January to December 2012. Results: Among 44 patients with penetrating pelvic injuries and underwent laparotomy were included. There were 27 therapeutic laparotomies, 9 nontherapeutic laparotomies, 8 damage control laparotomies. Small bowel was the most affected organ, follow by both colon and rectum organ. Hypovolemic shock was the major cause of death and surgical site infections were the most common complications. Conclusion: Despite, that nonoperative management is safe, penetrating wounds with transpelvic trajectory continue having an absolute indication for laparotomy in medical units in developing world.