Background - Ischemia time is a single major factor, determining outcome of a traumatic limb. It affects the degree of soft tissue injury. In India, due to lack of availability of vascular surgeons in periphery, patient often reach hospital after the golden hour of revascularization post traumatic injury i.e.,6 hours . We prospectively assessed such patients treated at our tertiary care institute in central India with ischemia time more than 10 hours and indicators affecting the outcome. Material and Methods- Our objective was to assess the outcome of the cases with ischemia time more than 10 hours with intervention done after the golden hour of revascularization with concomitant bony and vascular injuries. We have studied the indicators affecting the outcomes of these cases. 47 out of 58 patients who attended emergency medicine with concomitant bony and vascular injury were included in the study and were operated. We have assessed various parameter i.e., type of orthopedic and vascular intervention, presence of passive stretch pain or compartment syndrome and need for fasciotomy , type of bony injury and vessel injury , timing of surgery in both limb salvage and limb amputated group. Results - Total 47 out of 58 patients with concomitant bony and vascular injury had ischemia time more than 10 hours. About 10 patients underwent amputation (21.2%). Absence of passive stretch pain and presence of compartment syndrome was found to be significant and is said to be the major indicator determining limb salvage. Conclusion- Patients with vascular injury presenting after golden hour of revascularization should be promptly treated as per protocol targeting limb salvage. Early diagnosis and prompt treatment can prevent amputation and improve quality of life of the patients and decrease burden on society.