Profundoplasty was performed in 26 legs because of rest pain or gangrene; previous arterial reconstruction had been done in 12 of them. In 16 limbs the popliteotibial segment was patent; profundoplasty was successful in each case. In 10 limbs the popliteotibial segment was occluded, and profundoplasty failed in one instance. One patient died. The authors believe that re-establishing blood flow and pressure to the deep femoral artery, especially to the descending branch of the lateral circumflex artery and the distal part of the deep femoral artery can effectively improve the condition of ischemic legs.