Introduction: pelvic trauma is frequently associated with high-energy injuries and may result in severe complications due to the presence of vital visceral and vascular structures within the pelvic cavity. Visceral injuries related to pelvic fractures represent a major challenge in trauma management and often require multidisciplinary treatment. Objective: to review the most common visceral injuries associated with pelvic fractures and analyze their implications for general surgical management. Methodology: a narrative literature review was conducted using the databases PubMed, Cochrane Library, and Google Scholar. Articles published in English, Spanish, and Portuguese were considered. A total of 32 articles were initially identified, including original studies, review articles, and clinical reports. After evaluating relevance and scientific quality, 20 references were selected for inclusion in the present review. Results: Pelvic fractures are frequently associated with injuries to the bladder, urethra, rectum, and pelvic vascular structures. These injuries significantly increase morbidity and mortality, particularly in patients with unstable pelvic fractures and hemodynamic instability. Early diagnosis using imaging techniques such as computed tomography and CT angiography, along with prompt multidisciplinary management, is essential to improve patient outcomes. Conclusions: Visceral injuries associated with pelvic trauma represent a significant challenge for trauma care. Early recognition, appropriate diagnostic evaluation, and coordinated multidisciplinary management are essential to reduce complications and improve survival in these patients.