Fourteen cases of arterial bypass, utilizing autogenous saphenous vein, have been presented in which the distal anastomosis was to one of the three major vessels in the lower leg. There were two early failures. The remaining ten are functioning satisfactorily today. In some of these cases, the preservation of the extremity, as well as restoration of function, was quite dramatic. The technique has been generally that used for arterial surgery in other parts of the body. This technique permitted anastomoses in small blood vessels measuring 1.5 to 3 mm in diameter.