Traumatic vascular injuries are common in the multi-injured patient. Exposure and repair can often be challenging, particularly in the pelvis, chest, and distal carotid arteries. The explosion of endovascular technology over the last decade has brought innovative strategies to managing vascular trauma in the injured patient.( 1 ) Hybrid operating rooms provide the perfect opportunity to perform arteriography, minimally invasive proximal control, and therapeutic intervention, be it endovascular, open, or a hybrid combination thereof. In the absence of a hybrid operating room, an angiographic table and portable C-arm in the operating room is certainly acceptable. Percutaneous and hybrid techniques to manage nonaortic arterial trauma will be reviewed.