Background: Injury of the popliteal vessels is one of the most limb-threatening peripheral vascular injuries. The high morbidity after popliteal vascular injury can be explained by the fact that the popliteal artery is an end artery with an insufficient collateral supply; in addition, the popliteal vein provides the bulk of lower leg and foot drainage. Delays in diagnosis and interference in addition to associated complex tissue injuries would be associated with high amputation rate. However, high level of suspicion with early recognition and management by multidisciplinary team are necessary to optimize limb salvage. The aim of this review is to discuss the different factors that may affect the morbidity, incidence, presentation and diagnostic tools, various management options, and outcome of popliteal vascular injury.