Fifteen out of 3500 patients undergoing cardiac catheterization sustained arterial injury requiring surgical repair. Seven injuries to the common femoral or profunda femoris arteries presented late as false aneurysms, requiring simple suture repair. Three superficial femoral and four brachial artery injuries presented immediately after catheterization and surgical repair generally required the insertion of a vascular graft. The outcome of surgery was uniformly excellent. Small vessel cannulation is associated with increased likelihood of arterial injury. The common femoral route, with a high puncture site avoiding the superficial femoral or profunda vessels, is to be preferred to the brachial approach.