Endoluminal treatments have traditionally been restricted to a radiology suite, where an interventional radiologist is required. For this reason, this technology has had limited utility for trauma patients who have moderate to severe injuries. Now that vascular surgeons have incorporated endovascular techniques into their practice, the operating room is a radiology suite, and the surgeon is the interventionalist. Endovascular techniques provide an opportunity to improve trauma care by either temporizing a life-threatening injury or serving as the primary treatment. Using endovascular adjuncts does not preclude standard open surgery, nor does it prohibit an immediate or delayed surgical repair.