While most injuries to the chest can be diagnosed by a portable supine radiograph, computed tomography (CT) adds significant findings that will influence patient management. In addition to requested CT chest examinations, we routinely obtain a limited chest CT during the initial work-up of traumatized patients referred to our radiology department for other CT examinations. The major categories of new information provided by CT are: occult pneumothorax, malposition of chest tubes, inadequately drained pleural collections, differentiating between posttraumatic abscess and empyema, noninvasive diagnosis of tracheal rupture, and cause of mediastinal widening.