Objective To study the clinical features of duodenal trauma and its surgery to improve the level of diagnosis and treatment. Methods Methods of diagnosis and results of surgical treatment were analysed retrospectively of 35 cases of duodenal trauma. Results The positive rates of abdominal X-ray and abdominal puncture were 32.0%, 13.3% respectively. The extraperitoneal duodenal injuries occured in 30(85.7%) cases. 25(71.4%) cases were complicated by additional intraabdominal organ injuries. The rate of failure to diagnose intraoperatively was 11.4%. The postoperative complication rate was 37.1% and the death rate was 11.4%. Conclusion Duodenal trauma is characteristic of low diagnostic rate preoperatively, high failure rate intraoperatively and most of the cases are complicated by other intraabdominal organ injuries, so both the complication and mortality are high. If the diagnosis is certain, surgery should been taken suitably. This is the key to improve prognosis. The procedure performed is based on the condition of duodenal injuries.