AIM:To determine the association of unstable pelvic ring injuries with trauma code status.METHODS:A retrospective review of all pelvic ring injuries at a single academic center from July 2010 to June 2013 was performed.The trauma registry was used to identify level 1 and level 2 trauma codes for each injury.The computed tomography scans in all patients were classified as stable or unstable using the Abbreviated Injury Scale.Pelvic injury classifications in level 1 and level 2 groups were compared.Patient disposition at discharge in level 1 and level 2 groups were also compared.RESULTS:There were 108 level 1 and 130 level 2 blunt trauma admissions.In the level 1 group,67%of pelvic injuries were classified as stable fracture patterns and 33%were classified as unstable.In the level 2 group,62%of pelvic injuries were classified as stable fracture patterns and 38%were classified as unstable.level 1 trauma code was not associated with odds of having an unstable fracture pattern(OR=0.83,95%CI:0.48-1.41,P=0.485).In the level 1 group with unstable pelvic injuries,33%were discharged to home,36%to a rehabilitation facility,and 32%died.In the level 2 group with unstable pelvic injuries,65%were discharged to home,31%to a rehabilitation facility,and 4%died.For those with unstable pelvic fractures(n=85),assignment of a level 2 trauma code was associated with reduced odds of death(OR=0.07,95%CI:0.01-0.35,P=0.001)as compared to being discharged to home.CONCLUSION:Trauma code level assignment is not correlated with severity of pelvic injury.Because an unstable pelvis can lead to hemodynamic instability,these injuries may be undertriaged.