Abdominal vascular injuries are rare but carry significant morbidity and mortality, due to risk of hemorrhagic shock and rapid clinical deterioration. Abdominal vascular trauma is more common in men than in women, and while blunt mechanism dominates overall, penetrating abdominal vascular trauma is on the rise and poses a significant injury burden. Patients with major abdominal vascular injuries often have a concurrent solid organ or hollow viscus injury, and often, but not always, present with hemodynamic instability and peritonitis. Generally, stable patients should undergo CT angiography to better delineate injuries and determine next steps in management. Blunt abdominal vascular trauma can often be managed either nonoperatively or with endovascular techniques for more severe injuries, but penetrating injuries more frequently require operative exploration and repair. Postoperatively, patients are at risk for unplanned reintervention, infectious complications, and thromboembolic events. They also frequently require physical and psychological rehabilitation.