Background: Pediatric vascular reconstructions (PVRs) are rare and technically difficult operations. The combination of a technically difficult condition, with little established protocol and potentially devastating outcomes makes PVRs an important issue. Patients and methods: Retrospective analysis of a prospectively collected data, in a single tertiary academic centere.From January 2010 to January 2020, all children who had arterial reconstructions for trauma and malignancy are included. Results: The vascular injury patients were 34 and the tumor group were 8 (total = 42). Twenty patients repaired by end to end anastomosis, 12 patients repaired by using ipsilateral great saphenous vein graft used, 4 patients repaired by lateral arteriorrhaphy, 3 patients only fasciotomy, one patient ligation of the artery and one patient nephrectomy and lateral repair of IVC, one patient only application of papaverine. Early postoperative period showed that 34 patients had positive distal pulses and 8 had negative distal pulses. Long-term follow-up showed that 35 patients (83.3%) had no significant complications, normal growth and no discrepancy in length Conclusions: Early and in-time PVR could save life and leads normal limb growth and preventing permanent handicap. Vascular reconstruction malignancy may enhance long-term survival. Highlights