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Major vascular injury during lumbar laminectomy is an extremely rare complication of one of the commonest surgical procedures performed in orthopaedic and neurosurgical units. Its occurrence may be associated with high morbidity and mortality, particularly if it is not diagnosed in the early stages. Early diagnosis and repair is associated with an improved prognosis in the long term. We illustrate these points with a description of two cases, and discuss the anatomical factors predisposing to these injuries and the importance of angiography in the management and early diagnosis of suspected cases.