Accidental penetrating injury of the leg is common in the emergency room setting, and some patients have no bone injury on radiographs. We report a delayed sequel of vascular injury to the posterior tibial artery, following penetrating injury to the leg, which was later additionally complicated by pathological fracture of the proximal part of the fibula. Early diagnosis is important to provide timely treatment. The case of this patient illustrates that the delayed sequel of vascular injury may be confused clinically and on radiographs with a soft-tissue neoplasm. The patient was informed that data concerning the case would be submitted for publication, and he consented.