The A. report their own experience about 226 cases of by-pass and 46 cases of T.E.A. for aorto-iliac disease performed by the Department of Surgical Semeiotics in the University of Trieste. The results of 116 direct bilateral implants and of 23 monolateral implants are discussed. Intraoperatory mortality was about 8%. Early complications occurred in 9, 4%: thrombosis and prosthesis infections (5 cases) were the most important accidents. Late complications were thrombosis (19 cases), infection (1 case) and 2 A-E fistulas. It is possible to obviate late thrombosis with early reoperations. Long-term follow-up (106 patients) shows good results in 70, 8%, while thrombosis of the by-pass occurred in 17, 9%; 12 patients showed a distal ischemia of the limbs and required complementary reoperations. On the basis of their experience the A. stress that the results of aorto-femoral by-pass should be considered quite satisfactory.