Presented is the case of a motor vehicle accident (MVA) victim with hypotension and evisceration of small intestine. Vigorous resuscitation in the emergency department was required, after which a portion of small bowel was resected at laparotomy. Evisceration secondary to trauma in an MVA is a rare injury. Significant blood loss occurs. Although abdominal sepsis did not occur in our case, this is a complication for which the patient must be monitored closely.