Traumatic injuries and the physical impairments potentially associated with them can have debilitating or lethal consequences that can affect not only the health of the individual but also the population as a whole. Thus, the analysis of trauma is a common part of palaeopathological reconstructions of the lived experience in the past. A nuanced approach to trauma analysis informs this reconstruction by differentiating between traumatic injury secondary to underlying pathological conditions (e.g. osteoarthritis), trauma related to activity, including that related to occupation, and trauma resulting from interpersonal aggression. With regard to the latter, palaeopathological reconstructions of violence can add to current understandings of the use and patterns of violence within societies today and in the past. This temporal view is integral to an evolutionary medicine perspective, through examining how differential exposure to trauma has shaped humans biologically and culturally through time. Before reconstructions of traumatic patterns can be attempted, a base level of knowledge is required to identify morphological changes to bone and how these alterations differ from taphonomic damage or other pathological changes. This chapter sets out criteria for recording trauma in human skeletal remains and provides examples of how we use trauma to interpret patterns of injuries within the frameworks of bioarchaeology and evolutionary medicine, both accidental and violence-related.