The axillary artery and femoral artery and vein have much versatility for cardiovascular surgeons among the peripheral vessels that can be exposed, and they are able to be cannulated and anastomosed safely. They can be used for inflow or drainage line for extracorporeal circulation, approach site for impeller insertion, thoracic endovascular aortic repair( TEVAR) and transcatheter aortic valve replacement (TAVR). Therefore, it is important to establish a systematic exposure method for these vessels. The axillary artery has complex surrounding tissues, and unusual anatomical vessels reported in Japanese patients. A thorough understanding of its anatomy should be obtained to manipulate these vessels comfortably. The femoral artery is the most frequently used peripheral vessel, because it is relatively easy to expose. However, the difficulty may increase when exposing it in a semi-supine position taken in thoracoabdominal aortic aneurysm repair or minimal invasive cardiac surgery. The individual anatomical conditions of the femoral artery and vein should be assessed by preoperative computed tomography (CT) and intraoperative echocardiography to ensure an appropriate approach.