The records of 50 patients with 67 major civilian type vascular injuries treated in a large urban center from 1967-1975 were reviewed in terms of nature of the injury, form of surgical management and early and late results. Civilian injuries differ in many aspects from those of their military counterparts and often require different treatment. In both, treatment protocols should be periodically re-evaluated for a number of reasons, among which are changing patterns of delivery of the injured patient to the medical center and advances in technical skills. Notable in the presently reported series were the low mortality and the absence of a need for amputation, with a limb salvage rate of 100%. Despite modern advances in technical proficiency in vascular reconstruction, there is still a place for careful vascular ligation in the definitive surgical management of major vascular trauma.