Aortic bypass grafting was performed in 100 consecutive patients with disabling manifestations of aortoiliac arterial occlusive disease. There were no operative deaths, graft infections, false aneurysms, or aortoduodenal fistulas. Of those patients whose superficial femoral arteries were patent, 95% had a good or excellent immediate functional result that was maintained in 89% on late follow-up. Of those whose superficial femoral arteries were occluded, 83% had a similar immediate result and 70% maintained this improvement. Graft limb patency was 89% after 36 months. Additional distal arterial reconstructions were ultimately required in 9% of all limbs, resulting in a good to excellent functional outcome for 93% of all our patients. We believe aortofemoral grafting remains the best method for the correction of aortoiliac occlusive disease.