The results in 135 patients undergoing aorto-iliac and aorto-femoral bypass during 1974-1979 were examined. In most cases, occlusive disease of the iliac arteries was combined with total atherosclerotic occlusion of the superficial femoral arteries and sometimes with additional pathology in the profunda femoris artery. In 18.7%, subsequent vascular procedures became necessary in extremities of patients who had undergone aorto-iliac or aorto-femoral anastomotic procedures without additional profundoplasties. In those cases where the primary reconstruction was combined with profundoplasty the results were very satisfying and subsequent procedures were needed only in 8.8%. The aorta-profunda femoris bypass is now preferred for patients with combined aorto-iliac and femoro-popliteal occlusive disease. Results and technical details are discussed.