The increase in incidence of motor vehicle accidents has also increased the number of pediatric multi-trauma patients brought to trauma centers. Head, abdomen, genito-urinary system injuries, thorax trauma can be encountered simultaneously in those patients besides musculo-skeletal injuries. Anatomical and physiological differences in pediatric patients may cause more internal organ damage in kids than adults. Since the incidence of musculo-skeletal injuries in multi-trauma patients is very high, orthopaedic surgeons play an important role in the treatment of those patients. Damage control approach can be applied in those multi-trauma patients with pelvis and femur fractures in order to decrease the blood loss and prevent additional systemic complications. Although the principles of damage control surgery in adults has been discussed in detail, the literature lacks details in pediatric patients. The evaluation and treatment of pediatric multi-trauma patients necessitate collaboration of different departments, and support of a well organized intensive care unit. Evaluation of patients in an urgent manner through multidisciplinary approach and treatment of the injuries based on their priority is crucial. Therefore, defining the treatment algorithms and determining the team leaders who will lead the multi-trauma care before trauma admission is very important in tertiary medical centers.