The present report discusses the use of transcutaneous oxygen (PtcO2) monitoring in the perioperative management of a patient with two major peripheral arterial occlusions secondary to blunt trauma, during the performance of an external iliac artery thrombectomy and distal popliteal artery embolectomy. The injured limb PtcO2 was extremely low before surgery, but then increased to levels equal to and above contralateral limb PtcO2 a full 1 hour before skin closure. The injured limb PtcO2 correlated well with contralateral limb PtcO2 values after restoration of normal blood flow (r = 0.97). The ratio of injured limb PtcO2 to contralateral limb PtcO2 may be used to quantify the severity of arterial compromise in limb trauma and the adequacy of its treatment.