The posterior interosseous artery is a suitable donor vessel for harvesting autogenous arterial grafts which are often necessary for thumb or finger revascularization or replantation. Grafts 8 to 10 cm long can be taken from the dorsal ulnar aspect of the forearm ranging in caliber from 1 to 1.5 mm. The arterial graft can be harvested together with the lateral branch of the posterior interosseous nerve, offering the possibility of vascularized nerve transfer. Removal of the posterior interosseous artery does not influence peripheral perfusion or leave functional deficits. During dissection, care must be taken not to harm motor branches of the posterior interosseous nerve. We report a patient in whom this technique was used successfully.