Aim. To improve the results of surgical treatment of patients with lower extremities atherosclerosis and tibioperoneal trunk lesion. Material and methods. The study included 10 patients (7 men and 3 women) aged 52—76 years (64±3). All patients underwent femoropopliteal bypass with tibioperoneal trunk replacement. Results. In-hospital mortality was absent. Thrombosis of the graft was observed only in 1 (10%) patient. Conclusion. This method preserves adequate blood supply of leg and foot for a long time in case of prolonged occlusions of femoral, popliteal and tibial arteries, popliteal artery aneurysm. So, earning capacity and quality of life may be restored.