Results of surgical treatment were analyzed in 169 patients with critical lower limb ischemia and obliterating thrombangiitis. Patients were divided into 2 groups: 75 patients (control group) in perioperative period received basis treatment including anticoagulants, antiplatelets, dextrans, angioprotectors, antispasmodic agents, corticosteroids, narcotic and non-narcotic analgesics; 94 patients (main group) along with generally accepted therapy underwent prolonged epidural anesthesia (10-14 days). In early postoperative period (up to 30 days) frequency of secondary "major" limb amputation amounted 1.1% in the main group and 9.9% in the control group (p<0.05). Primary healing of operative wound after "minor" amputation on the foot was observed in 66.7% of patients in the main group and in 36% of patients in the control group (p<0.05). Active regeneration of ulcer defects on the foot occurred 1.7 times more often in the main group. It is drawn a conclusion that lumbar sympathectomy combined with prolonged epidural anesthesia provides impairment in results of surgical treatment and quick social rehabilitation in patients with critical lower limb ischemia and obliterating thrombangiitis.