Purpose: Polytrauma patients are of a higher risk of complications and death than the summation of expected mortality and morbidity of their individual injuries. The ideal goal in trauma resuscitation care is to identify and treat all injuries. With clinical and technological advanced imaging available for diagnosis and treatment of traumatic patients, point of care-rapid ultrasound in shock and hypotension (RUSH) significantly affects mod trauma services and patient outcomes. This study aims to evaluate the accuracy of RUSH and patient outcomes by early detection of the causes of unstable polytrauma. Methods: This cross-sectional, prospective study included 100 unstable polytrauma patients admitted in Suez Canal University Hospital. Clinical exam, RUSH and pan-computed tomography (pan-CT) were conducted. The result of CT was taken as the standard. Patients were managed according to the advanced trauma life support (ATLS) guidelines and treated of life threatening conditions if present. Patients were followed up for 28 days for a short outcome. Results: The most diagnostic causes of unstability in polytrauma patients by RUSH are hypovolemic shock (64％), followed by obstructive shock (14％), distributive shock (12％) and cardiogenic shock (10％) respectively. RUSH had 94.2％ sensitivity in the diagnosis of unstable polytrauma patients; the accuracy of RUSH in shock patients was 95.2％. Conclusion: RUSH is accurate in the diagnosis of unstable polytrauma patients; and 4％ of patients were diagnosed during follow-up after admission by RUSH and pan-CT.