Vascular injuries are extremely rare after lumbar disc surgery, but have high mortality. Nonetheless, early diagnosis and treatment of these injuries are lifesaving.

We present the case of a 38-year-old male patient with no history of disease or surgery. Our patient underwent microsurgical discectomy at the L4-L5 level and showed no evidence of intraoperative vascular injury, but vascular injury was later considered due to complications in the early postoperative period. Intraoperative autotransfusion was performed, and the operation was performed successfully. The patient was discharged on the 6th postoperative day with full recovery.

Hence, in lumbar disc surgery, the possibility of vascular injury should be considered, even when no findings of clinical significance are observed during the operation.