Vascular injury in the arm associated with trauma usually results from penetrating injury. However, this vascular injury can also be caused by open dislocation of the elbow or closed fracture of the humerus. Although the elbow joint is the third most common site of joint dislocation, closed elbow dislocations without associated fractures rarely have concomitant arterial injury. The authors report a case of complete disruption of the brachial artery associated with closed dislocation of the elbow and massive soft tissue damage. The patient was successfully managed by early diagnosis, prompt reduction of the dislocation, and end to end anastomosis of the brachial artery and fasciotomy.