Purpose of Review <p>This review aims to evaluate the evolving role of endovascular and hybrid techniques in the management of vascular trauma, with a focus on their application across various anatomical regions, including the torso, junctional zones, and extremities. The central questions addressed include: How have minimally invasive approaches impacted clinical outcomes in vascular trauma? What are the advantages and limitations of endovascular versus traditional open surgical repair?</p> Recent Findings <p>Recent registry data from the American Association for the Surgery of Trauma (AAST) PROspective Observational Vascular Injury Trial (PROOVIT) registry and guidelines from the American College of Cardiology, American Heart Association, and Society of Interventional Radiology highlight a substantial shift toward endovascular-first strategies, particularly for non-compressible torso hemorrhage and junctional vascular injuries. Techniques such as balloon occlusion, embolization, and stent grafting are now standard in many trauma centers. The use of hybrid operating rooms (Hybrid-ORs) has enabled the rapid integration of endovascular and open surgical methods, enhancing trauma workflow. Clinical studies demonstrate reduced mortality, lower blood transfusion requirements, and shorter hospital stays with these newer approaches. Thoracic endovascular aortic repair (TEVAR) is now recommended over open repair for blunt thoracic aortic injury (BTAI) due to superior 30-day outcomes. Emerging technologies such as bioresorbable stents, robot-assisted endovascular platforms, and advanced imaging modalities (e.g., IVUS, OCT) continue to push the field forward.</p> Summary <p>This review concludes that endovascular and hybrid techniques have fundamentally transformed vascular trauma management, offering safe, effective, and less invasive alternatives to open surgery. Key benefits include improved early survival, reduced perioperative morbidity, and faster recovery times, particularly in anatomically challenging or hemodynamically unstable patients. However, these approaches also require specialized training, long-term follow-up, and careful inventory and device management, as highlighted by the Characteristics and Results of Endovascular Devices in Trauma (CREDiT) study. Moving forward, multidisciplinary collaboration and ongoing research will be vital to refine indications, reduce reintervention rates, and support widespread adoption. The integration of technological innovations and clinical expertise will shape the next generation of vascular trauma care.</p>