Traumatic arteriovenous malformations (AVM) are formed by an abnormal and usually complex communication between arteries and veins. In contrast to congenital AVMs which occur most commonly in the head and neck, traumatic AVMs are usually reported in the extremities and are commonly the result of military conflicts. In 1757, William Hunter delivered his classical treatise on true and false aneurysms and described a traumatic fistula between the brachial artery and vein following phlebotomy. Approximately thirty cases of acquired traumatic AVMs of the facial region appear in the literature. Only two cases of acquired AVMs of the eyelid region have been reported--one of a post inflammatory origin and one which developed spontaneously. This paper presents the case of a large traumatic AVM of the right lower eyelid along with a discussion of the principles and management of these vascular lesions.