The purpose of this study was to examine the experience with extremity vascular injuries of a level II suburban trauma center. A retrospective chart review was undertaken to include all patients admitted in a 6-year period with vascular injuries to the extremities. The vessels injured were identified along with the mechanism of injury. The method of repair was recorded. All associated neurologic injuries were investigated. Follow-up records, when available, were reviewed. Between January 1, 1996, and November 30, 2002, 48 patients were admitted with 56 vascular injuries to the extremities. Blunt trauma was the mechanism in 24 patients while penetrating trauma was the mechanism in the other 24 patients. The limb salvage rate was 95 per cent. Of the 28 injuries to upper extremity vessels, 24 were associated with neurologic injuries. In contrast, only 3 neurologic injuries were found in patients with lower extremity vascular injuries. In contrast to most urban centers, the distribution of vascular injuries to the extremities in a suburban setting was equally divided between blunt and penetrating injuries. The majority of functional impairment was related to neurologic injury rather than tissue ischemia from vascular injury.