Diabetes mellitus is a major risk factor for the development of arterial occlusive disease. 2 kinds of diabetic angiopathy with different sequelae can be found needing surgical therapy after failure of conservative treatment; quite often it is necessary to perform an amputation sooner or later. By sufficient walking exercises and exact preoperative workup it is possible to find a favourable level of amputation. Good operative technique and early postoperative mobilisation of the patient can lead to complete rehabilitation.