During the period from 1970 to 1983 150 extra-anatomic bypass operations were carried out on 129 high risk patients revascularizing 157 extremities. There were 124 axillofemoral and 26 femorofemoral bypass grafts. In elective operations the mortality ranged from 4.9% for the axillofemoral bypass and 3.7% for the femorofemoral bypass. A five year postoperative follow-up showed a cumulative patency rate (according to life table method) of 80.21% for the femorofemoral bypass, 79.90% for the axillobifemoral bypass (Type IV) and 45.77% for the unilateral axillofemoral bypass (Type I and II). Considering the low operative mortality, the short operating time, the late results and the high late mortality independent of the surgical procedure, the femorofemoral bypass and in many ways also the axillobifemoral bypass represent suitable and effective methods of operation for high risk patients, whereas unilateral and bilateral axillofemoral grafts showed a high rate of graft thrombosis and poor long term results (Type I and III).