Vascular injuries during or after total hip replacements have often been reported. In 2257 artificial hip joint replacements, we observed 8 cases of vascular injuries requiring reconstruction (3 cases), suturing (2 cases), end-to-end anastomosis (1 case), or ligature (2 cases) performed by a vascular surgeon. A separate skin incision for vascular repair was necessary in all patients. Most of the injuries occurred as a result of technical errors through lack of caution when using bone hooks or rough handling, resulting in dislocation of the hip joint. The latter occurs mainly in revision procedures. Six patients recovered fully, but two died, one of hemorrhagic shock and the other of cardiac decompensation.