Twenty-four autologous vein grafts taken from the upper extremities were used in 13 patients undergoing aortocoronary bypass procedures. All of these patients had had previous bilateral saphenous vein stripping. Clinical follow-up between 3 months and 6 1/2 years is reported. Ten patients were recatheterized. There was neither operative mortality nor appreciable morbidity. All the patients are alive and well at the present time. Eleven out of 13 were in New York Heart Association (NYHA) Class I 3 months after operation. Nine patent grafts out of 10 were seen during recatheterization in 6 patients studied less than 9 months after operation. In a subgroup of 5 patients followed for more than 1 year, 2 are now in NYHA Functional Class I, 2 in Class II, and 1 in Class III. Graft patency had been determined in 4 of these patients. Five grafts out of 8 were patent, 2 of them with gross abnormalities. In conclusion, we have some reservations about the long-term fate of these grafts.