In cases of occlusion of the superficial femoral artery exceeding a length of 10 cm, accompanied by involvement of the popliteal artery and poor runoff, percutaneous transluminal angioplasty is unfavorable. However, when such advanced occlusive disease is present in patients for whom vascular surgery is not feasible, this technique can be of value by averting or at least postponing amputation. Percutaneous transluminal angioplasty was used to recanalize long segments (10-36 cm) of occluded or stenotic femoropopliteal arteries in 21 patients. Results were evaluated by means of pre- and postangioplasty arteriograms and measurements of pressure indices. The initial success rate was 76%; the success rate on 5-24 month follow-up was 67%. The long-term benefit can be improved by other measures, such as stopping cigarette smoking, exercise, long-term anticoagulation therapy, and early detection and treatment of restenosis.