Trauma systems are vital components of healthcare infrastructure, addressing the significant burden of severe injuries across Europe. Effective trauma systems improve patient outcomes and reduce mortality by providing timely, specialised care. However, significant disparities remain between countries, with only a few well-structured and maintained systems currently operating in Europe.Developing trauma systems requires collaboration among healthcare providers, emergency services, and government agencies. Standardised protocols for triage, transport, and treatment are essential, supported by robust infrastructure, public education, and injury prevention initiatives.Trauma systems comprise four core components:• Injury Prevention.• Pre-Hospital Care.• Facility Care.• Post-Hospital Care/Rehabilitation.These components rely on key elements such as leadership, professional resources, education, quality improvement, and funding. Political commitment, geographical considerations, and the efforts of dedicated clinicians are crucial for ensuring system success.Trauma systems across Europe are evolving under diverse healthcare structures. Over recent decades, dedicated clinicians, often with support from national medical societies, have initiated and sustained these systems. Typically, trauma hospitals, or trauma centres (TCs), are categorised into two or three levels, with the highest being 'Level I TC' or 'Major TC,' capable of managing the most complex cases. This chapter outlines general requirements for these categories, leaving individual nations to tailor standards to their healthcare systems.