Widespread fragmentation shells in combat operations with frequent multiple damage to organs and systems force to use all available diagnostic methods for treating severe injuries including lesion of great vessels of extremities. One of the consequences of these lesions is arteriovenous fistula (AVF). The last one may be asymptomatic at first. However, serious complications including circulatory disorders in extremities and severe heart failure can occur later. Thus, timely and correct surgical treatment can prevent these events. Open surgical treatment involves more careful mobilization of the artery and vein to prevent bleeding from dilated veins, as well as ensure arterial reconstruction. The authors present open surgical treatment of AVF in the right lower limb after previous mine explosion injury.