The Authors report the result of their ten-years experience with femoro-femoral crossover bypass in 26 patients affected with unilateral occlusion of the iliac artery. This bypass is an easy and quick procedure, useful in both short and long term. The patency rate after 58 months is 84.6%. Thus, its use indicated in a high number of patients, not only for a limb salvage treatment of a disabling claudication. The indications for this bypass can be extended to low surgical risk subjects, and it does not have to be considered only for the high-risk patients, instead of major surgery procedure on the aorto-iliac axis. The minimal necessary conditions of the limbs for performing the femoro-femoral crossover bypass are a pressure gradient of 35 mmHg and the angiographical demonstration of the unilateral occlusion. If the contralateral axis appears patent, but there are also multiple atherosclerotic sites, we consider other bypasses as therapeutical choices: aorto-bifemoral, ilio-femoral and the femoro-femoral cross-over itself; in the latter case we previously perform a transluminal angioplasty or an endarterectomy of the donor iliac artery. In these situations is essential to evaluate of the benefit/risk rate for every single patient.