INTRODUCTION: Following injury to the extremities and head, abdomen is the third most commonly injured part of the body. Blunt abdominal trauma is one of the common causes of morbidity and mortality among younger age group. Here we study clinical abdominal scoring system (CASS) in predicting the necessity of laparotomy in blunt abdominal trauma in the era of modern imaging modality. METHODS: 100 patient of blunt abdominal trauma were included in this study at SMS Medical College Jaipur over a period of six month (July 21 to Dec 21). Data were collected about incidence history, medical history, demographics, clinical examination, diagnostic and imaging test, management and outcome. RESULT: On admission for all 100 patient CASS was calculated. 29 patient fall in low risk group (<9 CASS) planned to manage conservatively (all improved). 14 patient were fall in high risk group (>12 CASS) planned to manage with immediate laparotomy (12 improved, 2 died). 57 patient fall in intermediate risk group (9-11 CASS) were followed with repeated clinical examination and modern imaging modality i.e. CT scan, 17 patient (out of 57~29%) were managed with laparotomy (15 improved, 2 died) and 40 patient (out of 57~71%) managed conservatively (all improved). CONCLUSION: CASS is promising in early detection of need of laparotomy in BAT patient, in equivocal result (intermediate risk group CASS) CT findings are useful for decision making about surgical vs. conservative management approach.