Driving with an arm protruding through a window can result in limb threatening injury. A series of seven upper limb injuries sustained during motor vehicle accidents (MVAs) with a limb protruding from the vehicle window is described. The severity and complexity of these injuries are related to the ultimate functional recovery for the limb. This study serves to highlight the severity of injury and morbidity following these modalities of trauma, which although rarely fatal, carry extensive consequences and could be easily prevented with appropriate education programmes and legislation.