The evolving nature of irregular warfare and the increasingly frequent violations of human rights law and international humanitarian law pose unique challenges for humanitarian actors delivering trauma care in conflict settings.

This review aims to map out the challenges faced by humanitarian actors while providing trauma care within conflict zones, examine the solutions suggested or implemented across varied past conflict scenarios as well as document any requirements for effective interventions.

A scoping review was conducted to analyze and review past humanitarian interventions offering trauma care in conflict settings. Relevant records were identified from scientific and grey literature. The thematic areas identified by the framework for a Public Health Emergency Operations Centre were used to facilitate the synthesis and analysis.

Eleven records examining all phases of conflict identifying gaps throughout the continuum of care in the trauma systems were included. Challenges, solutions and requirements in transportation capacity, data collection methodologies, field coordination mechanisms, and rehabilitative care services were highlighted. Addressing the shortages in skilled healthcare workers, implementing quality improvement measures, and developing standardized training curricula were some of the requirements reported.

Our review findings suggest that multidimensional approach emphasizing strong coordination, leadership, and inclusive partnerships is fundamental for effective trauma care systems in conflict zones. Key recommendations include robust medical transport, comprehensive healthcare training, preemptive mass casualty planning, standardized educational materials, telemedicine, continuous local context reassessment, data protection, and improved transparency and accountability. These strategies could enhance trauma care interventions, ensuring they are effective, equitable, accountable, and sustainable.