In 2007 the European guidelines for management of bleeding following major trauma were published after two years of systematic reviewing of published literature.The Task Force group was built multi-disciplinarily with cooperation of different European professional societies.The presenting author represents the European Society for Trauma and Emergency Surgery.Uncontrolled post-traumatic bleeding is the leading cause of potentially preventable death among trauma patients and is often attributable to a combination of vascular injury and coagulopathy.26 recommendations published in 2007 were updated in 2010 and recently with additional new recommendations on coagulation support, monitoring, use of tourniquets, local hemostatics, calcium, initial diagnostic/therapeutic procedures at the prehospital and hospital level.Revised guidelines 2010 have incorporated knowledge on severe injured patients treatment from civil and military sphere.Because the research and level of evidence accumulates the current state of the art guidelines will need to evolve accordingly.