The wide spreading of vascular diseases along with the emergence of minimally invasive endovascular therapies and modern medical therapies is inevitably bringing many disciplines into play. Although by definition, vascular surgery is the clinical and scientific discipline concerned with the diagnosis, treatment, and prevention of vascular diseases, many more radiologists and a significant number of cardiologists become increasingly involved. The question of which specialist among those qualified should carry out medical treatment, open, and endovascular procedures is still suspended, and a professional competition is pronounced. This article discusses the necessity of a vascular specialist who guides the holistic management of vascular diseases: open surgery, endovascular intervention, and medical therapy. The different characteristics of those intending to offer vascular care, the training curricula, the workforce demands, and the role of vascular centers are analyzed to illustrate the keystone role of vascular surgeons who are currently transforming to vascular specialists.