Aims: To present our experience from the diagnosis and treatment of axillary vein thrombosis in seven cases. Methods: We reviewed the medical records and x-rays of all the patients who were admitted and treated for axillary vein thrombosis (AVT) in the Orthopaedic and Vascular Surgery Departments of our hospital between 1995 and 2001. Results: We reviewed seven patients (þve males and two females, mean age 52.3 years old) presented in our hospital with AVT. Two of these cases occurred following musculoskeletal injuries (extrinsic trauma), three after central line insertion for oncological treatment (intrinsic trauma), one was related to the oral contraceptive pill (thrombophilic tendency) and one case was effort related (Paget-Schroetter syndrome). Clinically there was plethoria, arm swelling and persistent superþcial veins which were aggravated with activity and dependency. Venography or Duplex scan was used to establish the diagnosis. Causing factors and associated morbidity were assessed and treated. All of the cases of vein thrombosis responded well to conservative treatment (heparin/low molecular weight heparin for three months). None of the cases developed pulmonary embolism and we had no mortality. Conclusions: This study demonstrates that the innocent appearance of upper limb swelling should raise the index of suspicion of a potential underlying vascular lesion. Although quite rare, missed AVT may cause associated morbidity but very rarely mortality.