Background: Upper limb trauma is an injury caused by cutting, tearing, or crushing which leads to the limb becoming unrecognizable. In essence, there are two treatment options amputation and salvage reconstruction. Objective: The aim of this study was to assess the outcome of reconstructive surgery in upper limb trauma. Patients and Methods: This study was conducted upon 30 patients (24 males and 6 females) with mean age 28.53 ± 9.06 years presented with more than two elements, e..g. bone and tendons, vascular, nerve and skin. They were selected from Al-Azhar University Hospitals. They were admitted in General Surgery Department, Al-Azhar University Hospital, Faculty of medicine (Damietta), between April 2011 and January 2016. After appropriate consent, clinical assessment and radiological evaluation, reconstruction of upper limb trauma  by repaired tendons, vascular, skin injuries and bone fixation were done. Postoperative clinical assessments of sensation and function were done. Hand functions were grouped as excellent, good, fair and poor. Nerve injury was tested using both sensory and motor components, while assessment of the hand and fingers vascularity was carried out by original and modified Allan's test. All cases were followed up in first postoperative year for vascularity, sensation and functions of the hand. Results: For 30 patients over a period of a year of clinical follow up, there was marked reduction in morbidity and mortality with satisfactory significant improvement in upper limb and hand functions, and no ischemia, neuroma or tendon ruptures were observed during the follow-up period. Conclusion: Upper limb trauma reconstruction required a thorough understanding of the advantages and limitations of local, regional, distant, and free flap options. Only those wounds with exposed neurovascular structures, tendon, or bone typically require flap coverage. Multidisciplinary team can prevent or at least minimize post-operative functional disability of upper limb.