From 1988 to 1990, 34 operations for distal arterial revascularization aimed at lower limb salvage were carried out in 29 patients with arteritis lesions at stage IV with distal necrosis (52%), severe stage III arteritis (10%), severe acute or subacute ischemia (38%). The indications and therapeutic modalities are described and discussed. The results are compared with the data found in the literature. This is an availability and emergency surgery, the last means to avoid life-saving amputation. The rate of patent revascularization after one year can be as high as 85 to 90%. Almost 9 extremities out of 10 can be saved.