The extensive use of explosive munitions in modern warfare has led to a change in the distribution of sanitary losses and to greater severity of organ and tissue injuries. Improvements in the medical evacuation system have resulted in the formation of a specific group of wounded patients, whose defining characteristic is the presence of extensive combined gunshot tissue defects of the extremities. In this context, there has arisen a need to refine the concept of medical care for the wounded and to define a new multidisciplinary field. Analysis of the scientific data on combat-related surgical trauma and the authors’ experience revealed discrepancies between established military medical doctrine and contemporary requirements for specialized surgical care. In this work, a new treatment concept and the term “military reconstructive surgery of the extremities” are proposed. The concept of military reconstructive surgery of the extremities represents a system of interrelated principles and methods for the diagnosis and treatment of patients with combat-related extremity injuries. The term “military reconstructive surgery of the extremities” denotes a set of interdependent and mutually conditioned actions aimed at providing specialized medical care to wounded patients with combat-related extremity injuries in order to achieve the maximum possible restoration of the anatomy and function of the damaged extremities. Military reconstructive surgery of the extremities constitutes a component of specialized surgical care that requires a multidisciplinary approach and a complex of specialized diagnostic and therapeutic equipment, and represents a logical continuation of military field surgery.