This prospective 5-years research study describes 46 male patients with peripheral neurovascular injuries and is the largest reported series from this region at the present time. High-powered rifle injuries accounted for 91% of the lesions. Clavio-axillary region sustained 76% of the injuries. 3 patients presented directly with primary neurovascular injuries whilst the remainder (93%) presented at an average delay of 19 weeks when the neurological deficit was deteriorating (84. 7%) or had failed to improve (15. 3%) spontaneously. The predominant vascular lesion was a false aneurysm of various sizes in 84. 7% of the patients, whose progressive enlargement was thought to be aggravating the original neurological injury. The predominant neurological lesion was neurotmesis in 61% of the patients in one or more regional nerves and axonotmesis in 39% in whom the lesion was either static (39%) or was deteriorating (61%). In the emergency presentation, clinical and doppler evaluations were followed by one-stage neurovascular repair. Where the presentation was delayed, orderly investigations included electrophysiological, doppler and arteriographic studies in all patients. In the upper limbs, aneurysmectomy was performed for continued neurological decompression followed by revascularisation by long saphenous vein grafts. In the lower limbs, simple aneurysmtomy was followed by long saphenous vein grafts. External and internal neurolyses were performed for the involved segments of the nerves. Nerve grafts were performed using the harvested sural nerve. An operating microscope was used for group fascicular and epineural repairs. In cases where neurological reconstruction must be deferred, appropriate nerve tagging etc. must be performed to facilitate secondary nerve repair. In our series the early results were good, for both the vascular as well as neurological lesions but poor re-attendance on subsequent follow-ups has seriously affected the interpretation of the final outcome on a long term basis. It is hoped that this can be rectified through patient-education and better colleague co-operation in the future.