The thoracolumbar spine area at T10-L2 is the most common region of the spine affected by trauma due to the specific biomechanics of this segment. This area is commonly referred to as the thoracolumbar junction. It is highly susceptible to injury because it is a transition area from the rigid and less mobile thoracic spine due to the attached ribs bilaterally to a more flexible caudal lumbar spine. Injury to this area can result in a permanent neurological deficit from compression and injury to the conus medullaris or the descending nerve roots and warrants immediate attention and assessment. The most common mechanisms for thoracolumbar traumatic injuries include motor vehicle accidents, falls from height, recreational injuries, and work-related injuries. Most of them are high-velocity and high-energy injuries, which usually involve additional injuries. Consensus guidelines have been proposed for the systematic management and implementation of treatment algorithms, especially in multisystemic injuries. The American College of Surgeons provides the advanced trauma life support (ATLS) protocol for trauma providers, and evidence has demonstrated a reduction in morbidity and mortality with this implementation.