Lower extremity vascular traumas, though rare, are critical due to severe bleeding and ischaemic risks, often resulting from high-energy incidents like accidents or gunshot wounds. Immediate assessment and stabilisation are essential, focusing on haemorrhage control via compression, tourniquets, and haemostatic dressings. Damage control resuscitation aims to manage coagulopathy and optimise perfusion through balanced transfusion and early intervention. Definitive management involves surgical techniques such as vascular reconstruction or endovascular repair, tailored to the injury's specifics and patient's condition. Simple repairs are preferred, but complex cases may require grafts or advanced methods. Complications like compartment syndrome, haemorrhagic shock, and systemic inflammatory response syndrome can worsen outcomes, necessitating prompt and multidisciplinary intervention. Preventive and responsive measures, including early surgery and vigilant monitoring, are crucial for reducing morbidity and improving patient outcomes. Effective management integrates evidence-based practices, multidisciplinary approaches, and continuous research to enhance care quality and patient survival.