Vascular injury during total hip replacement is a rare condition with the incidence varying between 0.1% and 0.3%. However when develops, it has a potential of serious complications such as extremity loss and even death. Prompt identifi cation and appropriate surgical management of this condition are crucial and may decrease the rate of morbidity and mortality. In this report, we presented a case of iatrogenic iliac vein injury during total hip replacement and its successful surgical management.