A systematic and standardized approach should be applied to make a correct diagnosis when evaluating soft tissue injuries in orthopedic trauma. A detailed case history goes hand in hand with clinical, laboratory, and radiographic evaluation. Knowing the mechanism of injury may be important in predicting the severity of the injury. It should also be taken into consideration when making treatment decisions. Often, full assessment of the extent of soft-tissue injury can only be carried out in the operating room. All findings and diagnoses identified during the primary survey in the emergency department (ED) should be recorded in detail and documented on the patient`s chart. Photographic documentation of the soft-tissue injury is a necessity for the consulting specialists, further planning and decision making as well as for follow-up, scientific, or legal reasons. Several systems for the classification of traumatized soft tissues are in clinical use such as the Gustilo-Anderson classification, the Arbeitsgemeinschaft für Osteosynthesefragen (AO) soft-tissue classification, and the Hannover fracture scale. In recent years, the shortening of rescue times and the advancement of neurovascular repair techniques have led to a significant increase in the number of rescue operations in severely injured extremities. Many of early classification systems, such as the mangled extremity severity score, have tried to determine salvageability from a technical point of view. Recently, the more important question of which limbs should reasonably be salvaged from a functional point of view has received more attention.