This chapter is aimed to introduce the latest concepts in imaging patients with vascular trauma to all emergency clinicians; in particular traumatologists, intensivists and interventional radiologists. The clinical cases summarized and illustrated with their radiological pictorials are classical inductive vignettes for acute vascular imaging. Appreciating the mechanism of trauma during primary and secondary surveys can essentially guide the imaging protocols necessary to investigate exsanguinating causalities in any grades of shock. It is hoped that the readers will capture a brief description of the basic imaging characteristics coupled with a categorical haemodynamics status; which is very crucial for decision making and survival. Timely efficient clinical management is a skill required by those involved in the most fatal and complicated vascular trauma cases at small and/or large trauma centers.