Background: Polytrauma patients with intra-abdominal bleeding represent a critical surgical emergency with high early mortality, primarily due to uncontrolled hemorrhage and physiological collapse. In recent years, damage control surgery (DCS), combined with structured damage control resuscitation and multidisciplinary trauma management, has become a cornerstone in the care of these patients. Aim: This study aimed to evaluate the impact of early damage control surgery and comprehensive trauma management on outcomes in polytrauma patients presenting with intra-abdominal bleeding. Methods: A prospective observational study was conducted from August 2021 to February 2022 involving 375 polytrauma patients with intra-abdominal hemorrhage. Early DCS, standardized resuscitation protocols, perioperative critical care management, and staged definitive repair were analyzed. Results: Early implementation of damage control surgery, integrated with aggressive hemorrhage control, balanced transfusion strategies, temperature control, and intensive care management, resulted in significantly reduced mortality, shorter ICU stay, and fewer postoperative complications compared with delayed surgical intervention. Conclusion: Early damage control surgery, when combined with coordinated trauma management and damage control resuscitation, significantly improves survival and clinical outcomes in polytrauma patients with intra-abdominal bleeding.