Background: Major trauma is associated with high incidence of septic complications and multiple organ dysfunction (MOD). We assessed the prognostic value of serum and peritoneal procalcitonin (PCT) levels after trauma. Methods: We searched electronic database and included original studies that assessed prognostic value of PCT after trauma. We performed a retrospective analysis of the Intraperitoneal Vacuum Trial to assess correlation of plasma and peritoneal levels of PCT with clinical outcomes in patients managed with the open abdomen (OA) technique. Results: Among 2,015 citations identified, 19 studies met inclusion criteria. All studies showed a strong correlation between initial PCT levels and Injury Severity Score (ISS). Initial peak PCT levels predicted development of sepsis and MOD after trauma. Conclusion: PCT seems to hold promise as a surrogate biomarker for trauma. Initial peak PCT level may be used as an early predictor of sepsis, MOD, and mortality in trauma population.