Vascular injuries are present in less than 10% of poly trauma patients. However, major vascular injuries demand urgent treatment as death may result from rapid exsanguination if bleeding is not promptly controlled. Injuries may be direct due to blunt trauma (automobile accident) or penetrating trauma (missile, bullets, shrapnel, etc.). Indirect injuries are due to a bony fragment impinging on a vessel, classically seen in fracture shaft femur or humerus fractures. Iatrogenic injuries constitute the third group. Arterial injuries may be classified into. Contusion (this may lead to local thrombosis),puncture (leading to hemorrhage),laceration, intimal damage (causing intimal dissection or vessel thrombosis), partial division ,complete transaction ,false aneurysm (due to continuing bleeding which gets localized), arterio venous fistula (when there has been simultaneous injury to both artery and a neighboring vein. The signs of arterial injury have been classified as hard signs and soft signs. Detailed clinical assessment is outlined in the regional sections. If the diagnosis of arterial injury is evident (e.g. external haemorrhage, or limb ischaemia), no further investigation is required and patient is taken for operative treatment straightway: investigations may be helpful are plain radiography. They are taken for associated fractures/dislocations. Chest X-rays are useful in patients with chest injuries. Doppler pressure studies: a pressure difference of more than 20 mmHg is significant. The ankle/arm index, if lower than 0.9, is also diagnostic in absence of previous peripheral vascular disease. Colour Doppler (Duplex scan). This is useful in diagnosing false aneurysm, arteriovenous fistula and arterial thrombosis, but may not be of much use in an emergency situation. Angiography: the indications for arteriography in vascular injuries are suspected thoracic aorta injury, fracture pelvis with suspected retroperitoneal pelvic vascular injury, “soft signs” of vascular injury, abnormal Doppler study in suspected vascular injury. Computerized tomography angiography (CTA) has a much wider availability than conventional angiography, and has the potential to replace the latter in assessment of vascular trauma. Several methods are available for repair of vascular injuries. A small laceration may be repaired by simple suture or a lateral continuous suture. However, if this causes narrowing of the arterial lumen, a vein patch, harvested from any neighboring superficial vein should be used. Percutaneous catheter based (endovascular) techniques are increasingly being used to treat vascular injuries for control of Hemorrhage, obtaining temporary vascular control, and definitive vascular repair.