The updated European guideline on the management of bleeding and coagulopathy following major trauma emphasizes the importance of evidence-based recommendations to improve patient outcomes. The multidisciplinary Task Force for Advanced Bleeding Care in Trauma developed this guideline, which includes new recommendations on the appropriate use of vasopressors and inotropic agents, reflecting the growing number of patients treated with antiplatelet agents and oral anticoagulants. The guideline also covers thromboprophylactic strategies for all patients following traumatic injury and stresses the need for institutions to develop, implement, and adhere to evidence-based clinical protocols. Key recommendations include minimizing the time between injury and surgery, using tourniquets for life-threatening bleeding from open extremity injuries, and initial normo-ventilation for trauma patients without imminent cerebral herniation. The guideline also recommends early imaging for detecting free fluid in suspected torso trauma and monitoring coagulation using prothrombin time, activated partial thromboplastin time, fibrinogen, and platelets. Additionally, it suggests maintaining a target systolic blood pressure of 80 to 90 mmHg until major bleeding is stopped in the initial phase following trauma without brain injury. The guideline aims to ensure a uniform and high standard of care across Europe and beyond.The updated European guideline on the management of bleeding and coagulopathy following major trauma emphasizes the importance of evidence-based recommendations to improve patient outcomes. The multidisciplinary Task Force for Advanced Bleeding Care in Trauma developed this guideline, which includes new recommendations on the appropriate use of vasopressors and inotropic agents, reflecting the growing number of patients treated with antiplatelet agents and oral anticoagulants. The guideline also covers thromboprophylactic strategies for all patients following traumatic injury and stresses the need for institutions to develop, implement, and adhere to evidence-based clinical protocols. Key recommendations include minimizing the time between injury and surgery, using tourniquets for life-threatening bleeding from open extremity injuries, and initial normo-ventilation for trauma patients without imminent cerebral herniation. The guideline also recommends early imaging for detecting free fluid in suspected torso trauma and monitoring coagulation using prothrombin time, activated partial thromboplastin time, fibrinogen, and platelets. Additionally, it suggests maintaining a target systolic blood pressure of 80 to 90 mmHg until major bleeding is stopped in the initial phase following trauma without brain injury. The guideline aims to ensure a uniform and high standard of care across Europe and beyond.