Arterial injuries at the base of the neck are associated with a high mortality from uncontrolled hemorrhage and cerebral ischemia and, in survivors, frequently result in permanent crippling due to vascular insufficiency. This report is an analyses of 21 patients with proven major arterial injuries at the base of the neck treated at the City of Memphis Hospitals in the last 12 years. Etiology. —The incidence of arterial involvement from lacerations in this area cannot be proven due to the fact that many neck and shoulder lacerations are sutured and the patient sent home without hospital admission or long-term follow-up. In any case, a statement of the incidence of such wounds would have little clinical meaning. It appears that the majority of the gunshot wounds between the first intercostal space and the cricoid cartilage do involve major vessels. Likewise, only one of these 21 cases sustained a simple lacerating injury—this