This study analyzed 44 cases of penetrating pelvic injury (PPI) that underwent laparotomy at a hospital in Juarez, Mexico over one year. Most injuries were from gunshots. The small bowel was the most commonly injured organ. Therapeutic laparotomies were performed in 61.4% of cases where injuries required intervention. Major complications included surgical site infections. The mortality rate was 20%, primarily due to hypovolemic shock. Despite the safety of non-operative management of PPI in other settings, the lack of advanced imaging technology in this developing world hospital meant laparotomy remained the standard of care for penetrating pelvic trauma.