Over 500 upper extremities have been imaged with the Duplex Scanner at the John J. Cranley Vascular laboratory. Venous anatomy and imaging techniques are presented. Reference points and zones for localizing abnormal findings are demonstrated. Abnormal venous pathology including case presentations of acute radial, basilic, cephalic, and axillary vein thrombosis are presented. Complications of subclavian and internal jugular vein catheterization are demonstrated. Soft tissue pathology including edema, lymphadenopathy, hematomas, cysts, and abscesses are visualized and differentiated. Duplex use for evaluation of aneurysm, pseudo aneurysm and graft surveillance has been increasing in frequency. Examples are demonstrated.