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Abstract Vascular injuries are one of the most feared complications of orthopedic emergencies such as fractures and dislocations. The proximity of neurovascular structures to most of the long bones and major joints makes them more vulnerable to injury. A proper and repeated clinical examination is always advised for early diagnosis and prompt management of these complications in the emergency department. We present a case of delayed extensive thrombosis of upper limb arteries, one of the rare complications of closed posterior elbow dislocation managed by surgical thrombectomy.