This report deals with tibial arteries revascularizations performed on 28 patients since the year 1966 at the 1st Surgical Clinic of the Charles University of Prague, Czechoslovakia. Severeischemic changes with rest pain and necroses were the indications in 22 patients. In all cases a special method was used. It is a combination of semi-closed Thromboendarterectomy with saphenous vein bypass which is led along the vessels in the popliteal fossa to tibial arteries as far as the ankle region. This combination enables successful revascularization also in patients without a suitable saphenous vein.