A retrospective analysis of 391 intraoperative arteriograms performed after reconstruction operations on the carotid, aorta and lower extremity vasculature showed that use of this procedure routinely is valuable only for the last mentioned site. Revisions in technique have significantly diminished the incidence of inadequacies. Routine introperative arteriography for revascularization procedures of the lower extremity has enabled reliable classification of runoff and correlation of these findings with subsequent graft patency. Late graft closure, predominantly due to progressive or accelerated obliterating atherosclerosis in the distal circulation, occurred almost exclusively within the 1st yr following reconstruction in those patients identified as having poor runoff by intraoperative arteriography. This group, in particular, should be closely monitored by noninvasive means and postoperative arteriography to enable prophylactic or therapeutic correction. In some instances, intraoperative arteriography or subsequent studies obviates the need for reoperative vascular procedures.