Objective — to analyze the effectiveness of tibioperoneal trunk repair in autovenous femoropopliteal bypass surgery. Material and methods. There were 18 patients who underwent autovenous femoropopliteal bypass surgery with tibioperoneal trunk repair in 2016—2017. Mean age of patients was 70.3±12.2 years (range 54—81). Incidence of graft thrombosis in postoperative period, dynamics of chronic arterial insufficiency in pre- and postoperative period, mortality rate and the number of lower limb amputations were analyzed. Results. Femoropopliteal lesion TASC II type C was observed in 7 (38.9%) cases, type D — in 11 (61.1%). Acute arterial insufficiency grade IB—IIA followed by post-embolic occlusion of lower limb arteries was found in 5 (27.7%) cases. Chronic arterial insufficiency grade III was observed in 6 (33.3%) patients, grade IV due to widespread atherosclerosis of lower limb arteries — in 7 (38.8%). Primary patency of the grafts at discharge was 100%, after 1 year — 83.4%. In-hospital and annual postoperative mortality was absent. There were 3 (16.6%) cases of shunt thrombosis followed by recurrent critical ischemia within 1 postoperative year despite ongoing treatment. Conclusion. Incidence of clinical improvement (pain relief, healing of trophic disorders and complete restoration of limb function) and 1-year freedom from amputations were 83.4%.