We present a case of a 54-year-old patient with high body mass index (BMI) who presented with a traumatic knee dislocation with an associated popliteal artery occlusion after the patient's partner fell onto the affected patients' leg. This led to the patient requiring an urgent reduction in the emergency department (ED), followed by external fixation in theatre with popliteal artery bypass. This case highlights the importance of early recognition of vascular compromise and early reduction in the ED followed by relevant imaging.