Objective To investigate the reasons of misdiagnosis and missing diagnosis in blunt abdominal trauma (BAT), and to put forward effective preventive measures. Methods Literature on BAT diagnosis in recent years was reviewed. Results Misdiagnosis and missing diagnosis, which can take place in every segment of BAT patients, were still quite common nowadays. Conclusion Detailed case history collecting, faithful medical examination and making good use of assistant examinations can efficiently decrease the misdiagnosis and missing diagnosis rates of BAT patients.