Background: Paediatric vascular injuries differ from adult subjects in that significant injuries are more challenging to be detected since they are asymptomatic, are associated with spasm, or have other more serious life-threatening injuries which take priority in the resuscitation. Objective: This study was carried out to review the pattern of vascular injury in pediatrics, and its effect in outcome. Methods: This work was prospective observational clinical study that was carried out on pediatric trauma patients presented at Emergency Department (ED) in Mansoura University Emergency Hospital over period of one year, from September 2021 to August, 2022. The study included 103 patients. Results: The current study demonstrated that the majority of injuries were penetrating (62.1%), while 37.9% were blunt. Most of injuries were in the upper extremities, involving mostly brachial artery (28.3%), brachial vein (21.7%), and ulnar and radial vessels (23.3%). Regarding operative management lines, primary repair was performed in the majority of the cases (31.6%), followed by repair with vein patch (26.3%), and ligation (24.6%). The majority of the cases were admitted in ward (69.9%), while 30.1% were admitted in ICU. A statistically significant association was detected between injuries of the upper extremities and median duration of hospital stay among the studied cases. Conclusion: It can be concluded that optimal management of vascular injuries in children necessitates expedient diagnosis and treatment, with readily available access to a multidisciplinary team who have experience in paediatric trauma. The selective usage of arteriography is beneficial in injury diagnosis and subsequent surgical or non- surgical management. Computed tomography angiography can be a significant tool for initial evaluation.