BACKGROUND Central vascular injuries involving the thoracic and abdominal aorta, inferior vena cava (IVC), and iliac veins are rare but associated with high morbidity and mortality. Blunt traumatic aortic injury (BTAI), most commonly occurring at the aortic isthmus following rapid deceleration, is the best-studied entity. Current management includes anti-impulse therapy with heart rate and blood pressure control, non-operative management for low-grade (Grade I–II) injuries, and thoracic endovascular aortic repair (TEVAR) for higher-grade lesions. TEVAR is associated with lower early mortality than open repair, although optimal timing and long-term outcomes remain incompletely defined. METHOD We performed a 10 year retrospective audit (1 January 2015 – 31 December 2024) at Royal Perth Hospital in Perth, Western Australia, of all patients with traumatic aortic injury. Data collected included demographics, injury severity, physiology, management, follow up and survival outcomes. RESULTS 82 patients were identified, the average age was 43.6 years, 65 patients were male and 17 female. The Injury Severity Score ranged between 16 and 75. 64 patients were admitted to ICU during their admission. There were no patients managed with open operative techniques, 38 (46.3%) were managed conservatively and 44 (53.7%) were managed endovascularly. The median ICU length of stay was 3 days (range 0-65) and the median total hospital length of stay was 17 days (range 0-68). 33 (40%) patients died during their admission or on arrival to ED. CONCLUSION Traumatic aortic injury remains an uncommon but severe injury associated with significant polytrauma and critical care requirements. In this single-centre 10-year series, management was predominantly conservative or endovascular, reflecting contemporary practice trends favouring TEVAR where intervention is indicated. These findings provide local data to inform future studies evaluating long-term outcomes, surveillance strategies, and optimal patient selection.