To compare the predictive value of digital subtraction angiography (DSA) with B-mode ultrasonography in evaluating the arterial injury in high-voltage electrical burn of the forearm, 19 forearms sustaining high-voltage electric burn were examined with DSA and B-mode ultrasonography. During surgery, the involved arteries were examined closely to compare their gross pathology with the results of DSA and B-mode ultrasonography. The thrombotic or necrotic arteries found during surgery were excised and examined pathologically. Among 19 ulnar and radial arteries examined by DSA and B-mode ultrasonography, the abnormal signs were found in 14 ulnar and 11 radial arteries in DSA, including narrowing of lumen, beading of the wall, thrombosis, and slowing of blood flow, whereas abnormal signs were shown by B-mode ultrasonography in 19 ulnar and 16 radial arteries, including roughening, edema or exfoliation of the endothelium, thickening of vessel wall, narrowing of lumen, beading of the wall, and decrease in the blood flow. The vessels with severe injuries showed thrombosis or necrosis of the vessel wall. The aforementioned changes were confirmed during surgery and pathologic examination. B-mode ultrasonography is a more efficient tool than DSA in evaluating vascular injuries of the forearm sustaining high-voltage electrical burn.