Patients who suddenly become anuric and in whom no urinary obstruction is found should undergo arteriography both to confirm acute renal arterial occlusion and to plan surgical treatment. In acute renal arterial occlusion collateral circulation is often sufficient to maintain kidney viability and subsequent successful revascularization. Because there are no clinical or radiologic criteria to determine salvageability of the kidney, surgical exploration is advised in these patients. Such individuals who undergo successful renal revascularization often have gratifying return of renal function. Axillofemoral-renal bypass is suggested as a method to accomplish this objective.