Aim — to analyze the results of hybrid and open arterial reconstructions in patients with multilevel peripheral atherosclerosis. Material and methods. There were 147 patients with multilevel peripheral arterial disease who underwent vascular reconstructions in 2013—2018. The first (hybrid) group consisted of 72 patients after hybrid surgery, the second (open) group — 75 patients undergoing open surgical interventions. Mean age of patients was 65.8±7.9 years. In the 1st group chronic arterial insufficiency Fontaine—Pokrovsky stage IIB was diagnosed in 35 patients and critical ischemia in 37 ones. In the 2nd group these values were 29 and 46, respectively. Results. Mean time of hybrid and open operations was 219.2±85.1 and 207.8±75.1 min, respectively (p>0.05); intraoperative blood loss 218.9±134.6 and 390±216.9 ml, respectively (p<0.01). 30-day mortality was absent in both groups. 36-month primary patency was noted in 89.4 and 82.7% in both groups, respectively (p=0.29). Primary patency of infrainguinal segment was significantly higher in the first group: 80.2% after 12 months, 71.6% after 36 months. In the second group these values were 72.8 and 49.5%, respectively (p= 0.019). Limb salvage rate within 36 months was 90.1% in hybrid group and 78.4% in open group. Conclusion. Hybrid procedure including endarterectomy and subsequent endovascular repair is equally effective as open reconstruction in the treatment of multilevel peripheral arterial disease. This approach is followed by reduced intraoperative blood loss and time of surgery.