Vascular surgeries are procedures related to diseases of the blood vessels, the arteries and veins of the circulatory system of the body. Typically, this includes surgery of the aorta, carotid arteries, and vessels of the lower extremities. The quality of these procedures is thought to be dependent on patient volume, based on the assumption that complicated procedures are best performed by those who do it often, and that “practice makes perfect”. We conducted a systematic review of studies exploring the relationship between patient volume and quality in vascular surgery. We included 89 observational studies. We found that: higher volume had a possible impact on quality when evaluated on both surgeon and hospital level. higher volume had a possible impact on quality for both open and endovascular surgery. higher patient volume possibly reduces mortality for patients with abdominal aortic aneurysms, thoracic abdominal aortic aneurysms, carotid artery stenosis, peripheral vascular disease and renal artery disease. higher patient volume also possibly reduces complications in patients with abdominal aortic aneurysms, carotid artery disease and peripheral vascular disease, and length of stay (hospital days) in patients with abdominal aortic aneurysms and carotid artery disease. there is a need for more studies evaluating the volume-quality relationship for patients with acute admissions, and for studies assessing outcomes such as length of stay and cost.