The Arizona-Mexico border consists of 375 square miles of rural desert where temperature extremes, excessive sun exposure, and a lack of food and water are common. The desert poses an especially deadly threat to immigrants who attempt to cross it on foot. In an effort to smuggle humans across this region, smugglers transport people in vans that are loaded beyond the recommended vehicle weight limitations. The unrestrained occupants change the vehicle's center of gravity and increase the propensity for van rollovers. Van rollovers produce multiple casualties that quickly outstrip the resources of rural providers. The purpose of this article is to describe two cases that involved multiple victims injured in van rollovers that occurred on two consecutive days. The rollovers occurred in the rural areas outside of Phoenix, Arizona, and eventually taxed the entire metropolitan Phoenix area trauma system. Copyright © 2005 by the Emergency Nurses Association.

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