To prevent amputation continue to be a significant challenge when polpiteal vascular injuries occur. From January 1, 1983 until December 31, 1990, thirty consecutive patients with polpiteal vascular trauma were admitted to Severance Hospital. The mean prehospital time was 5 hours 30 minutes. The mean preoperative time was 12 hours 6 minutes. A retrospective review of cases from Severance Hospital identified 30 patients of 24 blunt trauma and 6 penetrating injury; There were 16 amputations. The open comminuted proximal tibia fracture and crushing injury on lower leg were particularly limb threatening. The extent of soft tissue trauma was most important determinant of limb salvage. An aggressive multidisciplinary approach is required to achieve a functional extremity when popliteal trauma occurs.