The case is described of a man who feigned being struck by a vehicle, leading to an unnecessary major trauma response by the ambulance service and hospital. Suspicion that the patient suffered from Munchausen syndrome was confirmed by later investigation. Accident and emergency staff should file details of such patients on the department computer records system, where available, so that staff are alerted automatically to their presence, and share this information with neighbouring hospitals. All such patients should be treated according to ATLS guidelines until injury is ruled out, as for any other patient.