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Purpose Traumatic injuries to the pancreas are rare and only represent 4% of all abdominal injuries after trauma. These injuries are associated with a significant increase in morbidity and mortality. Their early diagnosis is essential, since lack of treatment results in serious complications that endanger the patient's life. We present three cases of pancreatic trauma with delayed diagnosis, established only after serious complications, and a revision of the current diagnosis and management of pancreatic trauma. Materials and methods Case 1: A 49-year-old woman who, 2 months after a fall, presents with severe pancreatitis and diffuse peritonitis. Patient was diagnosed with complete transection of the Wirsung duct. Case 2: A 29-year-old woman who consults about abdominal pain 6 months after a difficult birth. Patient was diagnosed with complete transection of the Wirsung duct and giant pancreatic pseudocyst with acute hemorrhage. Case 3: A 30-year-old woman who consults about abdominal pain 2 months after falling from her bicycle. Patient was diagnosed with complete transection of the Wirsung duct and pancreatic pseudocyst with acute bleeding Results Distal pancreatectomy with splenectomy was performed in the first and third cases, while in the second case, it was possible to preserve the spleen with satisfactory recovery in all three cases. Conclusion Complications after pancreatic trauma are frequent. Many contributing factors exist, including not only management but also diagnosis of the pancreatic injury. A high index of suspicion is the most important factor in reaching a diagnosis. How to cite this article Fuertes MJ, Navarro DC. Managing Pancreatic Trauma: The Importance of Suspicion. Panam J Trauma Critical Care Emerg Surg 2012;1(2):131-136.