Background Diabetic lower limb ischemia is a serious complication of diabetes mellitus.This study was conducted toinvestigate the effectiveness of distal arterial bypass treatment in diabetic patients with lower limb ischemia.Methods From July 2000 to July 2004,96 lower limbs of 82 diabetic patients (type 2) with severe lower limb ischemiawere treated in Xuan Wu Hospital.Arterial bypass with femoro-popliteal polytetrafluoroethylene (PTFE) and graft-tibialautologous grafts was performed on 31 limbs (32.3%).Popliteal-tibial artery bypass alone was performed on 22 limbs(22.9%).Combined lilac artery stenting,femoro-popliteal artery PTFE graft bypass,and graft-tibial artery autologous graftbypass was performed on 12 limbs (12.5%),and femoro-tibial artery graft bypass was performed on 10 limbs (10.4%).Popliteal-tibial-pedal artery graft bypass was performed on 7 limbs (7.3%).Results Arterial grafts in 92 limbs of 79 patients were patent on discharge.Three patients with 4 ischemic limbs (3.7%)died of respiratory failure 12 hours,3 days and 7 days after operation respectively.Early operation success rate was96.3% (79/82).Graft patency rate of patients on discharge was 95.8% (92/96).The short-term total effectiveness ratewas 83.3% (80/96).Foot ulcer healing rate was 35.7% (10/28).97.4% (75/77) patients were followed up for a mean of13.5 months.The long-term total effective rate was 80.7% (71/88).The total amputation rate was 4.5% (4/88).Mortalitywas 4.5%.The total graft patency rate was 90.9% (80/88).Conclusion In the treatment of diabetic foot,distal lower limb arterial bypass can help to avoid amputation or lower theamputation level,and may promote foot ulcer healing and improve patient’s quality of life. Background Diabetic lower limb ischemia is a serious complication of diabetes mellitus. This study was conducted to investigate the effectiveness of distal arterial bypass treatment in diabetic patients with lower limb ischemia. Methods From July 2000 to July 2004, 96 lower limbs of 82 diabetic patients (type 2) with severe lower limb ischemiawere treated in Xuan Wu Hospital. Arterial bypass with femoro-popliteal polytetrafluoroethylene (PTFE) and graft-tibiallautologous grafts was performed on 31 limbs (32.3%). Popliteal-tibial artery bypass alone was performed on 22 limbs 22.9%). Combined lilac artery stenting, femoro-popliteal artery PTFE graft bypass, and graft-tibial artery autologous graft bypass was performed on 12 limbs (12.5%), and femoro-tibial artery graft bypass was performed on 10 limbs .Popliteal-tibial-pedal artery graft bypass was performed on 7 limbs (7.3%). Results Arterial grafts in 92 limbs of 79 patients were patent on discharge. Three patients with 4 ischemic limbs (3.7% ) died of respiratory failure for 12 hours, 3 days and 7 days after operation respectively. Early operation success rate was 96.3% (79/82) .Graft patency rate of patients on discharge was 95.8% (92/96). The short- term total effectiveness ratewas83.3% (80/96) .Foot ulcer healing rate was 35.7% (10/28) .97.4% (75/77) patients were followed up for a mean of13.5 months.The long-term total effective rate was 80.7% (71/88) .The total amputation rate was 4.5% (4/88) .Mortalitywas 4.5% .The total graft patency rate was 90.9% (80/88) .Conclusion In the treatment of diabetic foot, distal lower limb arterial bypass can help to avoid amputation or lower theamputation level, and may promote foot ulcer healing and improve patient’s quality of life.