Patients with severely diseased or occluded infrageniculate arteries, limited runoff, and tissue loss may often present for primary amputation. In this study, we review our experience with plantar artery revascularization when no other bypass options are feasible. All patients requiring infrainguinal bypass to the plantar artery level over the last 3 years were prospectively entered into our vascular surgery database. Indications, demographics, length of stay (LOS), outcome, and patency were reviewed. Our results showed that plantar artery bypass is a safe and reasonable alternative to primary amputation. Excellent limb salvage can be achieved if the bypass remains patent through the initial 30 days postoperatively.