Purpose: To describe the epidemiology of myocardial injury in trauma patients. Method: A one-year retrospective study ending on 31/08/2023 was conducted at a Level-1 Trauma Centre. All adult trauma resuscitation patients with elevated troponin serum concentration were included. Patient demographics, medical history, mechanism, injury severity, laboratory data, cardiac investigations, LOS, ICU admission and mortality were collected. Patients were categorised into three groups based on the timing of their Troponin peak (Group1:<12hours; Group2:12-24hours; Group3:>24hours). Results: From 1408 admissions, 97(7%) patients (Age:56±24yrs; Male:71%; ISS:18,IQR25; LOS:14±16; ICU:66%; Mortality:16.5%) had elevated Troponin. Group1 (n=37; Age:48±23; Male:76%; ISS:9 IQR18; LOS:14±21; ICU:51%; Mortaliy:5.4%); Group2 (n=32; Age:51±24; Male:78%; ISS:27,IQR41; LOS:11±6; ICU:84.3%; Mortaliy:25%) and Group3 (n=28; Age:71±19; Male:57%; ISS:19,IQR38; LOS:17±15; ICU:64%; Mortaliy:21.4%). 64% of patients had thoracic injuries, which was consistent among the three groups. Group 3 had most frequent ECG (61%) and echocardiography (29%) findings. Conclusion: Troponin elevation occurs in 7% of all trauma admissions and it identifies the seriously injured high-risk cohort. The timing of the maximum Troponin concentration seems to describe three distinct phenotypes. “Hyperacute”, “Subacute” with severe polytrauma and tissue injury requiring major resource utilisation and associated with increased mortality rate, and “Late” characterised by ECG and ECHO changes suggesting primary ischaemic cardiac pathology rather than blunt trauma and hyperinflammation related as in Acute and Subacute phenotypes.