Isolated infrarenal vena caval injury following blunt trauma is rare. In most patients, poor clinical status usually precludes imaging prior to laparotomy. When CT is performed, however, signs that allow a diagnosis of caval injury to be made are (a) retroperitoneal hematoma with paracaval epicenter; (b) irregular vena caval contour; and (c) extravasation of contrast-enhanced blood from the cava.