The aortoiliac occlusive disease, known as Leriche syndrome, primarily merits an aortobifemoral bypass graft which is the standard surgical treatment of critical limb ischemia. However, axillofemoral bypass grafting can be also used as an alternative treatment in highrisk patients. The indications include intraabdominal graft infections, older age, and worsened overall status. In this article, a successful salvage of a limb with an axillofemoral bypass surgery in a critical leg ischemia subsequently developed soon after an acute myocardial infarction was reported.