We discuss how trauma and PTSD shape people’s lives in Baltimore and beyond, and how activists, service providers, educators, and government agencies are using knowledge of trauma to change the city. We learn about legislation mandating that city agencies use trauma-informed practices when delivering services, find out where trauma fits into peace and reconciliation on an international scale in places like South Africa and Northern Ireland, and hear about how harm reduction activists incorporate trauma into the work they do supporting sex workers and people who use drugs in Baltimore.