This study examined the association between central capillary refill time (CRT) and mortality in adult trauma patients, with particular focus on those presenting with hemodynamic stability. Using data from the CRASH-2 trial—which enrolled over 20,000 trauma patients across 274 hospitals in 40 countries—this secondary analysis included 19,054 patients with complete CRT measurements. CRT was measured centrally at the sternum and categorized into three groups: ≤2 seconds, 3–4 seconds, and ≥5 seconds. Logistic regression models, adjusted for country-specific effects, assessed 28-day mortality and secondary outcomes including transfusion requirements, surgical interventions, and venous thromboembolism (VTE). Results demonstrated a stepwise association between prolonged CRT and increased risk of adverse outcomes. Compared with patients with CRT ≤2 seconds, those with CRT of 3–4 seconds had a 1.7-fold increase in odds of death (95% CI, 1.6–1.9), while CRT ≥5 seconds was associated with a threefold increase in mortality risk (OR 3.2; 95% CI, 2.8–3.5).This association persisted in patients with normal heart rate and blood pressure. These findings indicate that CRT can detect occult hypoperfusion not identified by conventional vital signs. Prolonged CRT was also associated with increased rates of blood transfusion, thromboembolic events, and surgical interventions.Receiver operating characteristic analysis demonstrated moderate discriminative ability, with area under the curve (AUC) values ranging from 0.63 to 0.74. This indicated the ability of moderate discrimination.