Purpose To describe involvement of vascular surgery in management and outcomes of soft tissue sarcoma in a state sarcoma service. Methods Prospective data was collected from 2010 to 2022 on patients undergoing resection under the state sarcoma team in Western Australia. Involvement of vascular surgery, length of stay, mortality and graft patency was collected. Tumour type was determined through histopathological analysis. Descriptive analysis was performed, and comparative analysis using chi-squared test and binary logistic regression. Results 129 patients underwent surgery for soft tissue sarcoma, mean age 58.6 years (17-81), predominantly female (51.2%). Majority were de-differentiated liposarcomas (34.9%), well-differentiated liposarcomas (15.6%) and leiomyosarcomas (10.1%). 76.2% of cases required vascular surgery involvement. 10.9% had arterial reconstruction, most for de-differentiated liposarcomas (35.7%), majority (71.4%) with polytetrafluoroethelene (PTFE) graft. 20.2% had venous reconstructions, majority for leiomyosarcomas (30.8%), with 69.2% PTFEs. Mean length of stay was 19.6±16.9 days. Inpatient mortality was 2.3% and 1-year mortality 9.3%. Each increment in age was associated with 2.86 times increase 1-year mortality rate (p=0.009). Both arterial and venous reconstructions were not associated with 1-year mortality. 12 month arterial and venous graft patency was 57.1%, and 69.2% respectively. Patients on apixaban had 100% (n=2) arterial graft patency at 1-year, rivaroxaban 40% (n=2) and warfarin 66.7% (n=2). Venous graft patency was 100% for apixaban (n=4), 66.7% (n=8) rivaroxaban, and 75% (n=3) warfarin. Conclusion There is significant vascular surgical involvement in soft tissue sarcoma resection, with arterial and venous reconstructions. 1-year mortality and graft occlusion rate remain high, with further investigations needed to evaluate effectiveness of various grafts and anticoagulation modalities and its effect on long term patency.