Trauma is still a leading cause of death in the 21st Century mainly due to uncontrolled hemorrhage. Trauma has also an increasing cost of treatment in patients. Recently we have been aware of the importance of complex hemostatic and immunoinflammatory responses in pathogenesis of "Trauma Induced Coagulopathy". As a result of understanding of changes on coagulation pathway in trauma, different hypotheses put forward explaining the trauma induced coagulopathy. New treatment algorithms also take place in early coagulation management of patients with traumatic coagulopathy. In this review, we aimed to explain pathophysiological determinant of trauma induced coagulopathy and recent evidence-based hemostatic treatment approach for patients with trauma.