We present the case of a 79-year-old woman who presented at our center with a periprosthetic tibial fracture with a popliteal artery injury after total knee arthroplasty. Anastomosis of the popliteal artery was performed on the day of injury, and was later treated by open reduction and internal fixation. The patient was able to walk 3 months after injury. The present case was difficult to treat because of the arterial injury associated with periprosthetic fracture. Although revision of the implant was considered, open reduction and internal fixation was selected because of the severity of soft-tissue damage. The mechanism of injury is not uncommon, and it is expected that similar fractures will become more prevalent in the future as the number of knee replacement surgeries increases. •We experienced a case of periprosthetic tibial fracture after total knee arthroplasty with popliteal artery injury.•There have been no reports of periprosthetic fracture associated with popliteal artery injury.•Because this injury process is not specific, the chances of encountering this injury are expected to increase in the future.