Purpose Traumatic peripheral arterial injury in children is rare but may be limb- or life-threatening. Published data on management of paediatric vascular trauma remain limited. We performed a retrospective descriptive analysis of paediatric vascular trauma and associated outcomes in North Queensland. Methodology A retrospective review was conducted. All vascular surgical procedures performed in paediatric patients from January 2016 to June 2025 in Cairns and Townsville University Hospitals were included. Only twelve patients underwent revascularisation in the setting of a traumatic extremity injury. Patients with non-reconstructible vascular injury or those managed non-operatively were excluded. Vascular reconstructions performed by non-vascular surgeons were also excluded. Results Twelve patients were included. Half of this cohort presented acutely with distal limb ischaemia. Vascular reconstruction procedures performed included vein patch angioplasty, anatomical bypass grafting with autologous vein conduit, interposition grafting, primary arterial repair and endovascular covered stenting. No patients suffered limb loss. No patients developed ischaemic limb contracture, limb length discrepancy, or claudication. 67% of patients were prescribed antiplatelet therapy. Conclusion Paediatric vascular trauma of the extremity remains rare. There is notable variance in approaches to open and/or endovascular revascularisation, post-operative antiplatelet or anticoagulant therapy, and surveillance methods utilised. All appear to be effective in limb salvage.