BACKGROUND: Distal femoral tumour resections are mostly performed through a medial or anteromedial approach. The lateral parapatellar approach is an alternative method. This case series assessed vascular complications during the resection of malignant distal femoral tumours via the lateral parapatellar approach METHODS: A retrospective case series at a private practice in Pretoria was performed. All patients who underwent malignant distal femoral tumour resections through a lateral parapatellar approach between 2001 and 2019 were included in the study. All cases were performed by a single surgeon. An analysis of the patients' files was performed, to determine if there were any intraoperative or immediately postoperative vascular complications RESULTS: Thirty-six patients were identified who underwent resection of their malignant distal femoral tumours via the lateral parapatellar approach. Osteosarcoma was the most prevalent bone tumour (81%). All resection margins were clear on histology reports. The vascular complication rate was 3% (95% CI 0-8%). Twelve patients demised over the 18-year period (33% CONCLUSION: The findings suggest that a low risk of vascular complications can be expected when resecting malignant distal femoral tumours through a lateral parapatellar approach. This rate of vascular injury is comparable to other studies that also performed distal femoral tumour resections through other approaches Level of evidence: Level 4 Keywords: malignant distal femoral tumours, lateral parapatellar approach, vascular complications, tumour resection, endoprosthesis