The literature and original research data on the incidence of combined lesions of coronary arteries, abdominal aorta, and lower-limb vessels are presented. Operative intervention was undertaken in 112 of 170 examined patients with combined coronary and vascular abnormalities. Fifteen patients underwent one-stage reconstruction of the coronary artery and aortofemoral segment; in 57 patients aortocoronary bypass was performed as the first stage; in 40 patients only vascular reconstruction was performed. Operative risks in these patients are discussed, as well as the diagnostic problems, surgical tactics, and the sequence of operation stages in combined coronary and vascular abnormalities.