Current knowledge of physiopathology allows better understanding of the metabolic and immunological alterations that occur after trauma, thus allowing more adequate treatment. Nutritional support is recognized as an important therapeutic intervention to promote wound healing, reduce the risk of infection and improve survival. The patient with severe trauma needs nutritional support from the beginning of treatment. The early administration of enteral nutrition is an important factor in the reduction of gut bacterial translocation and thus of septic complications. In the early phase, the parenteral route is capable of providing a sufficient calorific and protein support, whilst awaiting the recovery of the enteral route.