Background and Aims Pancreatic trauma, resulting from various factors leading to structural or functional damage to the pancreas, is typically categorized into closed and open injuries. However, pancreatic trauma is not common, and when it occurs, it often accompanies injuries to multiple organs. The unique anatomical location of the pancreas poses challenges in diagnosis and treatment, contributing to the high mortality rate associated with pancreatic trauma, which is often related to delays in diagnosis and treatment. In recent years, with the advancement of industrialization in China, there has been an increasing trend in the incidence of pancreatic trauma, which is also influenced by geographical factors. Therefore, this study was performed to summarize the causes, injury grading, and treatment modalities of pancreatic trauma over a 15-year period at a single center, with the intention of gaining experiential guidance for clinical practice.Methods The clinical data of 147 patients with pancreatic trauma admitted to the First Affiliated Hospital of Air Force Military Medical University from January 2008 to December 2022 were retrospectively analyzed. Pancreatic trauma was graded according to the criteria of the American Association for the Surgery of Trauma (AAST), and the causes, injury grading, corresponding treatment modalities, as well as outcomes were analyzed and summarized.Results There were 15 cases of open injury and 132 cases of closed injury. The most common etiological factor was motor vehicle accidents, accounting for 65 cases (44.22%), followed by physical altercations (blunt or sharp) in 28 cases (19.05%), falls from height in 18 cases (12.24%), other traumas in 10 cases (6.80%), non-traffic-related falls or collisions in 8 cases (5.44%), compression injuries in 4 cases (2.72%), blast injuries in 1 case (0.68%), and 13 cases (8.84%) of injuries with unknown causes. According to the AAST criteria, there were 58 cases of grade I (39.46%), 15 cases of grade Ⅱ (10.21%), 54 cases of grade Ⅲ (36.73%), 9 cases of grade Ⅳ(6.12%), and 11 cases of grade Ⅴ (7.48%). Surgical intervention was performed in 80 cases (54.42%), with a surgery rate of 95.95% for high-grade injuries (grade Ⅲ-Ⅴ). Surgical procedures included distal pancreatectomy in 44 cases, pancreaticoduodenectomy in 11 cases, pancreaticojejunostomy in 5 cases, pancreatic debridement, repair, and drainage in 19 cases, and combined pancreatic head and pancreatic duct repair with distal pancreatectomy in 1 case. ConservatⅣe treatment was performed in 62 cases (42.18%), and endoscopic treatment in 5 cases (3.40%). Among the conservatⅣely treated patients, 24 cases (38.71%) were cured, 37 cases improved, and 1 case died. Among the surgically treated patients, 66 cases (82.50%) were cured, 9 cases improved, 3 cases deteriorated, and 2 cases died. All 5 patients undergoing endoscopic treatment showed improvement.Conclusion The causative factors of pancreatic trauma are commonly associated with traffic collisions, physical altercations, and falls from height. For grade Ⅰ-Ⅱ pancreatic trauma, conservative treatment is mostly feasible, while grade Ⅲ-Ⅴ primarily require surgical intervention, especially distal pancreatectomy or pancreaticoduodenectomy. Prompt surgical intervention is necessary for severe high-grade pancreatic trauma, and even for low-grade injuries, appropriate proactive intervention should be selected based on actual conditions. Pancreatic trauma requires individualized treatment plans based on the pathogenic factors, injury severity, the patient's overall condition, and the medical capabilities of the institution.