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The recently published review by Hatchimonji et al in Trauma Surgery & Acute Care Open assesses the role of the resuscitative endovascular balloon occlusion of the aorta (REBOA) in penetrating abdominal trauma, using the Trauma Quality Improvement Project (TQIP) data.1 This study describes a retrospective series of patients who underwent this endovascular procedure in the emergency department and performs a propensity matching to compare outcomes between those who did not. Their conclusion is categorical: REBOA patients are associated with delay to definitive bleeding control, greater transfusion requirement, leg amputation, and mortality. Although the results are of high significance, they partially contradict previously published studies; thus, we have some concerns that need to be analyzed.