Successful repair of both arterial and venous trauma is now attainable. Techniques of repair are established and technical complications should be avoided. Challenges remain, nevertheless, in combined arterial and venous injuries, concomitant unstable fractures, and associated massive soft tissue destruction. Additional investigative work is required to help settle some controversial points, particularly regarding the use of adjunctive measures. Long term follow up of patients sustaining vascular trauma is mandatory. Potential changes such as intimal proliferation at the suture line, aneurysmal formation in grafts, and acceleration of arteriosclerosis at the site of injury are neither thoroughly documented nor completely understood.