When obtaining vascular access on a burn patient, there are numerous options with their individual benefits, risks, and complications. Placement through unburned tissue, all things being equal, is preferable to placement through burned tissue; that is, an intravenous line should be placed through the right antecubital space in the setting of a left antecubital burn. Peripheral lines in the upper extremities are optimal; however, cut-downs are contraindicated, given the inordinate infection rate associated with them. Any line may be placed through burned tissue, if necessary, but lines through eschar should be removed within 72 hours, given the high colonization and infection rates beyond that time period. Central venous catheters are beneficial for those requiring prolonged treatments with large volumes of fluids (i.e., large burns or inhalation injury), invasive hemodynamic monitoring, total parenteral nutrition, or certain medications. Theoretically, peripherally inserted central catheters avoid some of the disadvantages of classical central lines, but their efficacy and place in the management of the severely burned patient have yet to be clinically defined.