Traumatic hemorrhagic shock (HS) is a severe outcome of traumatic injury that accounts for numerous traumatic deaths. In the process of traumatic HS, both hemorrhage and trauma can trigger a complex cascade of posttraumatic events that are related to inflammatory and immune responses, which may lead to multiple organ injury or even death. From a mechanistic perspective, systemic inflammation and organ injury are involved coagulation, the complement system, impaired microcirculation and inflammatory signaling pathways. In this review, we discuss the systemic inflammation and multiple organ injury in post-traumatic HS.