Introduction: The common imaging modalities used for the diagnosis of pelvic and abdominal trauma range from ultrasonography, X-ray, computed tomography, and others. In each different kind of abdominal condition, a different modality is preferred depending on the nature of condition, the patient, and the hospital facility where the management is provided. Some conditions require more than one source of imaging. Aim of the work: In this study, our aim was to discuss various abdominal and pelvic pathologies separately to explore the preferred type of imaging modality. Methodology: we conducted this review using a comprehensive search of MEDLINE, PubMed and EMBASE from January 1994 to March 2017. The following search terms were used: ultrasound versus CT, abdominal radiology, acute abdomen imaging, pelvic pain diagnosis. Conclusion: Blunt abdominal traumas are very common with many causes including motor vehicle accidents, bicycle accidents, and falls. Appropriate and early management of blunt abdominal trauma is essential to prevent the occurrence of significant long-term morbidities and high mortality rates. Due to non-specific clinical manifestation, establishing a proper diagnosis mainly depends on radiologic modalities.