Vascular injuries most often occur in road traffic, industrial and domestic accidents, as well in steel arms damages and firearms. According to the literature, mortality in vascular injuries averages 18%. In damage to lower limb vessels in peacetime, incidence of amputations is up to 8%, mortality — 5%. Early diagnosis of arterial damage is one of the most important objectives in modern vascular surgery, since successful surgical treatment often depends on the time and quality of specialized medical care. Moreover, delay and underestimation of the risks of arterial wall injury can be fatal for the patient. The authors report successful surgical treatment of a patient with popliteal artery injury. The choice of access for combined trauma with arterial damage and thrombosis is essential for successful surgery. In case of internal arterial injuries, positional revision of vascular bundle with direct thrombectomy and subsequent vascular reconstruction (repair or replacement for traction injury) are required. In this case, detachment of the intima required replacement of the artery. Surgical treatment prevented amputation and provided complete rehabilitation.