The acute ischemia of the lower extremities represents a serious threat for limb and life and needs emergency treatment. The results of surgical therapy concerning a twelve year period were demonstrated (172 lower extremities in 156 patients). There was an operative mortality of 37.8% and an amputation rate of 9.6%, 2 years survival rate was 48.3% and run up to 37.1% after 5 years. Regarding to outcome age, primary disease, preexisting arterial occlusive disease, early reocclusion and prolongation of ischemic interval have proved as limiting factor resulting in unsatisfactory early results.