Background
Arteriovenous fistula (AVF) formation is an uncommon clinical manifestation of arterial trauma. A delayed diagnosis of AVF of 15 years had been reported, underscoring the potential for missing these injuries.

Patient Presentation
A fifty years old male presented with left lower limb heaviness and pain associated with leg swelling, color changes, ulcerations and offensive discharge with physical signs of traumatic AVF at site of previous trauma and vascular exploration

Results
Successful surgical repair of long standing left sided traumatic femoro-femoral fistula.

Conclusion
In long standing traumatic AVF, the final surgical procedure undertaken will ultimately be determined by peroperative findings whatever the initial preoperative plan was.