INTRODUCTION: Fractures with arterial injury requiring vascular repair are high grade and severe injuries with soft tissue being compromised. Uniform approach and experience in the management of these fractures is relatively uncommon. External fixation followed by definitive fixation has been on the rising trend. The main aim of this study is the analyze the mode of injury, time and patterns of presentation, and the outcome of fractures associated with vascular injuries. We followed up 84 fracture patients with vascular injury who were admitted in a span of one year. In our study, we had a limb salvage rate of 71.5%, 25% primary amputation rate and 3.5% secondary amputation rate. CONCLUSION: A good clinical examination and vascularity assessment by hand held doppler alone is vital for limb salvage due to immediate intervention. Definitive fixation following initial external fixation should be done as soon as possible for early mobilization.