Sixteen extremities with severe femoropopliteal occlusion in 11 patients were treated by common femoral-profunda femoris (CF-PF) endarterectomy. In all 16, autogenous reconstruction could be carried out. Symptoms of rest pain in seven and claudication in nine were relieved. In those patients tested, treadmill testing and intraoperative flows increased substantially after reconstruction. It is concluded that this operation is effective in selected patients with femoropopliteal occlusive disease, and should be considered as an alternative to bypass procedures, particularly in those with CF-PF obstruction.