In a series of 140 patients operated upon for aortoiliac occlusive disease over 11 1/2 yr, 81 had concomitant occlusion of the superficial femoral artery. These 81 patients with combined segment disease were studied with particular emphasis on the relief of presenting symptoms by an aortic bypass procedure alone. Fifty-three patients underwent only aortic bypass and could be fully evaluated postoperatively. Ninety-six per cent presenting with rest pain or ischemic changes obtained complete relief of these symptoms. All 53 patients presented with claudication, and 88.7% either had complete relief or improved to the point that no further therapy was needed. The results of this study confirm the efficacy of restoration of proximal flow to the profunda femoris arteries as the primary therapeutic goal in patients with combined segment disease.