Prompt recognition and treatment of this grave injury by blood replacement and newer surgical technics is offering an improved salvage rate in recent years.THE INFERIOR VENA CAVA lies comparatively well protected by surrounding viscera and musculoskeletal structures, and injuries to it are relatively infrequent. When this vessel is damaged by penetrating or blunt trauma, exsanguination causes death in many patients before they can reach medical attention. Ochsner, Crawford and DeBakey1report that 36% of patients proven to have acute wounds of the inferior vena cava die before admission to the hospital. Many patients who survive long enough to have an operation also die from the combined effects of massive hemorrhage and damage to associated organs. Wood,2in a review in 1966, was able to find only 57 patients who had survived surgical correction of a penetrating wound of the inferior vena cava. As is seen in table 1, improved survival rates are being obtained with increasing experience in management of these injuries.The present report affirms the serious consequences of injury to a large, thin-walled, high flow vessel but indicates that an appreciable salvage rate is possible.