Ten patients with duodenal perforation secondary to blunt abdominal trauma [mostly related to motor vehicle accidents] are reviewed. All 10 patients survived. Early recognition requires a high index of suspicion because preoperative signs and symptoms tend to be nonspecific and X-rays are usually not helpful. A careful exploration of the duodenum at laparotomy including both the Kocher maneuver and the Cattell-Braasch exposure is essential. Suitable methods of surgical repair are numerous, but those providing for restoration of normal gastrointestinal tract continuity are preferred.