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Lower extremity vascular injuries occur due to gunshot wounds, traffic accidents, penetrating and blunt injuries, or industrial injuries. Gunshot wounds with vascular injuries have been increased among the civilian population. Lower extremity gunshot wounds have severe and acute complications of bone fractures, abundant bleeding, hypovolemic shock, soft tissue disruption, acute ischemia, neurological deficit, limb loss, or even death. The amputation rate of the popliteal injuries differs between 27% and 54%. In this paper, preoperative management and surgical experience in the popliteal region vascular injuries in three massively impaired cases were presented. Different surgical approaches performed in these patients due to the variety of pathologies were also discussed. [Arch Clin Exp Surg 2017; 6(4.000): 228-232]