Hemorrhage, in particular, noncompressible torso hemorrhage, remains a significant contributor to mortality in trauma cases. Despite many advances in resuscitation, noncompressible sites of bleeding have presented a particular challenge. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is one technique that can be used to temporarily stop hemorrhage from these sites to allow transfer to definitive care. Although the technique is relatively straight-forward, it carries significant risk, in particular, from ischemia due to aortic occlusion. This article describes the role and considerations for the use of REBOA in the critically injured patient.