Blunt or penetrating trauma to the chest can cause injury to the aorta and its major branching arteries. These injuries are still the second most lethal condition in blunt trauma patients, after head injuries, and need urgent detection and treatment. In this chapter, we will specifically discuss aortic and proximal branch vessel injuries resulting from blunt trauma mechanisms. These are almost invariably resulting from high-impact trauma, usually with rapid deceleration forces. Patients sustaining blunt traumatic aortic injury (BTAI) usually have many concomitant injuries, that will distract from scrutinizing the aorta. This chapter will help radiologist understand BTAI and be a valuable partner in the resuscitation team, both in diagnosis and treatment of BTAI.