In 227 patients 252 extremities were operated on with femoropopliteal bypass using the in situ vein technique. The valves were extirpated through incisions in the vein. At discharge 14 grafts were thrombosed, mainly because of inadequate size of the vein graft. Ten years after surgery more than 50% of the patients had died, and only 25% of the implanted grafts were patent. The dominating cause of death was coronary infarction. Thirty one limbs were amputated. At the end of follow-up 51 grafts were patent 10 to 17 years after surgery, mean 10.84 ears. With regard to mortality and long term patency the most important factors were: Preoperative history of myocardial disease, smoking, size of the vein graft and peripheral "run-off".