Plasmapheresis was applied to treat 67 patients with lower extremity vessel atherosclerosis obliterans. A total of 92 therapy courses were performed, which involved 250 sessions of plasmapheresis (205 with a PF-0.5 apparatus and 45 with plastic bags and centrifuge). During the course, an average of 160% volume of circulating plasma were removed to be replaced with crystalloids and dextrans. A positive effect shown by a 6.9-fold increase in the distance covered by patients who experienced no pains and by resting pain relief was achieved in 93.8% with Stage II circulatory failure and 75% with Stage III, regardless of the severity of vascular lesions. It was shown that it was necessary to make a "programmed" plasmapheresis when the patient received 2 plasmapheresis courses a year. The mechanism of a positive effect of plasmapheresis remains unclear. A significant plasmapheresis-induced decrease was observed in the concentration of "acute phase proteins" (plasma fibrinogen and globulins), which plays the leading role in improving blood rheology, which seems to affect clinical outcomes.