Polytrauma patients represent the ultimate challenge to trauma care and the optimization of their care is a major focus of clinical and basic science research.Scores are very important to the scientific study of the epidemiology and treatment of trauma. Trauma systems are vital components of trauma care chain. The present study was conducted to identify the role of injury severity score in polytrauma patients.The study was conducted at MIOT Hospitals, Chennai, India from 1–Oct–2014 to 1–Dec–2015 for a period of 14months.One hundred and forty nine cases of polytrauma with musculoskeletal injuries were selected and classified as stable, borderline, unstable and in extremis and received either ETC or DCO on the basis of different parameters including AIS and ISS score. There is definitely a role for ISS scoring in the classification of polytrauma patients and which will definitely affect the future management protocol of the patient. This will helps identify patients with polytrauma with low chances of survival, and to allow a fair comparison between different trauma patient .Although ISS is the most widely accepted anatomical score, there are major limitations with this approach