Cardiac complications after operations on aorto-iliac segment take the leading place, and they are the main cause of postoperative lethality achieving 40%. Experience of 10 simultaneous operations on coronary and aorto-iliac zone with original method of aorto-femoral bypass from mini-approach is analyzed. The types and stages of simultaneous reconstructions are described. The clinical case of simultaneous operations on brachiocephal, coronary and lower limb arteries is presented with characteristics of surgical stages and the main intra- and postoperative parameters. Mini-invasive methods permit to expand the indications for simultaneous operations on different vascular segments at the patients with multifocal atherosclerosis.