A ratcheting adjustable vascular compression device assists in achieving partial or full occlusion of a blood vessel when applied to a patient's limb, during or following a medical procedure. During deployment, a compression pad on the device applies preferential compression to at least one portion of the circumference of the limb. Further, securement, adjustment and rapid release of the device are all enabled by an alternate ratcheting mechanism that enables gradual adjustments to be made to the tightness and thus to the compression applied without releasing the device, so as to permit patent blood flow through blood vessels in the limb during the compression period.