Major vascular injuries in closed fracture of the pelvis occur in approximately 1% of cases. In this setting, subadventitial rupture of the external iliac artery is rare. The lesion is responsible for acute ischemia of the lower limb, and may present diagnostic challenges due to frequently associated major local injuries, delayed disappearance of distal pulses, and concomitant neurological damage. Serial clinical examinations along with the use of arteriography are instrumental in avoiding undue delays.