Purpose: Hybrid operating rooms (HORs) integrate surgical operating, advanced imaging and endovascular interventional capabilities without inter-department transfer. We surveyed Level-1 trauma centres in ANZ to quantify HOR availability, utilisation and governance, and to inform trauma care verification standards. Methodology: A 47-question online survey included all 30 ANZ Level-1 trauma centres. Items captured HOR availability/plans, integrated imaging, trauma utilisation and volume, access criteria/decision-making, governance/protocols, barriers/challenges, tracked metrics and reported outcome change. Descriptive statistics are reported. Results: The survey achieved 30(100%) responses. A functional HOR was reported by 18(60.0%), while 5(16.7%) are in the planning or commissioning phase and 7(23.3%) have no such facility. Among the 18 centres with a functional HOR, all utilise the room for non-trauma cases. While 16 (88.9%) also use the facility for trauma, only 7 (38.9%) prioritise or dedicate the HOR specifically for trauma patients. In the centres with trauma-capable HORs, all 16 units are located within the operating suite. Integrated angiography is part of the HOR in 14 centres (85.7%), but only 4 hospitals (25%) integrate diagnostic CT. The HOR utilisation for trauma care is fewer than five cases per month in 14 centres (87.5%). Protocols are established in 10(62.5%) of trauma centres, only 4(25%) actively track outcome metrics. Among the centres without a functional HOR, financial constraints are the barrier in 9(75%) centres, in addition to lack of physical space in 6(50.0%) centres. Conclusion: HORs exist or are planned in 77% of the Level-1 Trauma Centres but they are underutilised or unavailable for trauma care. Based on their near-ubiquitous status, if international evidence supports their positive impact on outcome, functional trauma HORs might be considered as essential verification criteria for ANZ level-1 and 2 trauma centres.