The authors report twenty-one cases of bony and vascular trauma of the popliteal fossa. The first step in the appropriate treatment of these lesions is to be aware of the associations of the two types of lesion, independent of the degree of bony damage; an isolated dislocation may be associated with a sub-adventitial rupture of the popliteal artery. Surgical treatment consists of bony fixation followed by vascular repair, which requires autologous popliteo-popliteal or femoro-popliteal venous by-pass grafts in 90 per cent of cases. This repair should concern both the artery and the vein, as the immediate prognosis depends on the complete repair of both vessels. The immediate results essentially depend on the nature of the traumatic aetiology: gunshot wounds, or motor vehicle accidents, and on the quality of the vascular repair. The long term prognosis depends on the quality of the orthopaedic treatment. In every case, the classical reputation of the severity of such associated lesions is fully justified.