The final outcome in the cases reported here clearly emphasizes the importance of early diagnosis. In three of the five cases, amputation was required because the condition was not recognized in time. Pain and tumescence in a previously injured extremity and sometimes fever, mimicking sepsis, should alert the surgeon to the possibility of a slow arterial leak, even when the peripheral circulation is normal and there is no bruit or pathological pulsation. Arteriography should be performed whenever the diagnosis of slow arterial leak is considered.