The existence of symptomatic aortoiliofemoral occlusive vascular disease appears to result in approximately a 10 yr decrease in life expectancy compared to that of the normal population. However, a significant proportion of the cumulative mortality rate appears to be due to both coronary artery disease and diabetes mellitus, as patients with peripheral vascular disease had a near normal life expectancy in the absence of either coronary artery disease or diabetes mellitus. Neither the presence nor the anatomical location of occlusive disease distal to the common femoral bifurcation by itself decreased life expectancy compared to those patients with aortoiliofemoral disease but without similar distal occlusive disease. Low operative mortality rate, excellent long-term patency and potentially normal life expectancy all encourage an aggressive operative approach in patients with symptoms of peripheral vascular disease but without either diabetes mellitus or coronary artery disease. Revascularization in those patients with diabetes mellitus should be directed at limb salvage rather than at relief of minor symptoms of ischemia.