The authors analyse a series of 45 vascular trauma treated during the period 1965-1980. It is very important to make a diagnosis as soon as possible and to limit the interval accident-operation. In 40% of our cases we had to operate rather late. Most of those cases were secondary transfers of other hospitals. Arteriography should be performed if there is any doubt. Now we always perform an angiogram during the operation. If there is any associated orthopedic injury, this is handled first, if possible by external fixation. A fasciotomy can be of value to save a limb. Any venous injury should be repaired also.