According to the American College of Surgeons' Advanced Trauma Life Support (ATLS®) Protocol, specific x-rays are recommended in order to determine the presence of possible injuries in a trauma patient. One of these films is the anteroposterior (AP) pelvic radiograph. It is unclear whether it is still necessary to obtain the AP (anteroposterior) pelvic radiograph or if the initial abdominopelvic computed tomography (APCT) alone is sufficient to determine all pelvic injuries. We compared the AP pelvic radiograph to the initial APCT scan in identifying acute pelvic injuries. Radiology reports of trauma patients with acute pelvic injuries, evaluated by AP pelvic radiograph and APCT from March 1, 2003-February 28, 2005, were retrospectively reviewed. 245 such patients were identified at Arrowhead Regional Medical Center, a Level II trauma center. 575 of 595 pelvic injuries were detected by APCT or AP pelvic radiograph. The APCT detected 495 (83% sensitivity) pelvic injuries and the AP pelvic radiograph detected 402 (68% sensitivity). Of the 575 detected, 80 (14%) pelvic injuries detected by radiograph were undetected on the initial APCT report. 173 (30%) pelvic injuries detected by APCT were undetected by the AP pelvic radiograph report. 322 (56%) were simultaneously detected by radiograph and APCT. The CT was more sensitive in detecting ilial, sacral, acetabular, and sacroiliac fractures. The AP pelvic radiograph was more sensitive in detecting ischial fractures and pubic diastases. We observed that, together, the AP pelvic radiograph and abdominopelvic CT were 97% sensitive in detecting all pelvic injuries present. The AP pelvic radiograph and APCT complement each other in the evaluation and diagnosis of blunt trauma patients. The APCT is inconclusive in detecting all acute pelvic injuries, and therefore, the AP pelvic radiograph should not be eliminated from standard protocols when it is indicated.