Objective To investigate the clinical characteristics and operative treatment of humeral super-middle fracture combined with brachial artery injury. Methods 9 cases of humeral super-middle fracture combined with brachial artery injury have been treated in our department since 2000 with reduction, axial external fixation, and autotransplantation of great saphenous vein to repair brachial artery. Results All patients were followed up for 1 to 2 years. No stenosis occurred at the anastomosed veins and the limbs survived well. All fractures achieved clinical healing except 1 case who had nonunion following refracture and had to undergo secondary operation. Conclusion The operation is simple and easy, but effective in treatment of the humeral super-middle fracture combined with brachial artery injury.