Abstract: Objective: To discuss the experience in diagnosis and treatment of the major arterial injury in limbs.Methods: The clinical data of 23 patients with the major arterial injury in limbs between January 1996 and July 2006 were retrospectively analyzed.The injured arteries were repaired by arterioplasty,ligation,end-to-end anastomosis,great saphenous vein graft,artificial blood vessel graft,embolectomy with Fogarty catheter.Results: Three patients were amputated in limbs.Twelve patients were followed up from 3 months to 5 years.One patient suffered from low extremity ischemia.One patient had ischemic muscular atrophy in low extremity.Conclusions: Early diagnosis and improvement of recognition of arterial injury are the key to increase the survival of the limbs and avoid the occurrence of false aneurysm.The method of operation,embolectomy with Fogarty catheter and early fasciectomy can increase salvage.