The results of 157 consecutive autogenous saphenous vein bypass grafts followed for periods up to eight and a half years are presented. The operations were performed on 145 patients with the following indications: (1) intermittent claudication (41%); (2) rest pain (25%); (3) gangrene (34%). The early patency rate in patients with intermittent claudication was 83%, and of these 83% remained patent; with rest pain, 74% and of these 86% remained patent; with gangrene, 63% and of these 76% remained patent. The success rate was highest in (1) nondiabetic patients; (2) extremities with two or three patent vessels at the level of the popliteal trifurcation; (3) extremities in which short grafts were used, whether or not the reconstruction crossed the knee joint. Angiograms on 29 patent grafts and 12 thrombosed grafts revealed: (1) absence of atheromatous changes in the grafts; (2) absence of aneurysmal dilatation in the body of the graft; (3) an equal incidence of progression of original disease in patent grafts and in late thrombosed grafts. Autogenous venous bypass grafts function well in the arterial system for prolonged periods. The results continue to support the superiority of vein grafts over both thromboendarterectomies and synthetic-tube bypass grafts in the treatment of femoropopliteal occlusive disease.