During the war in Croatia, the surgical department of Osijek Hospital was the place of primary and definitive surgical management of the wounded from the city of Osijek and the entire northeastern region of Croatia. Our surgical experience with the management of war injuries of major extremity vessels, collected from May 2, 1991, through April 12, 1992, is reviewed. During that time, 60 wounded were admitted to the hospital with injuries of major blood vessels of the extremities, all of them directly from the battlefield or from the streets of Osijek. The method of surgical treatment depended on the type of vascular injury and associated injuries. Our methods were arterial injury reconstruction and monitoring of the early results when autogenous vein grafts or synthetic prostheses were used. The results indicate that one should not resist using synthetics for reconstruction of arterial injuries in a highly contaminated area.