The general caution in the diagnosis of elderly patients needing vascular surgery is not always founded and should remain the right of the surgeon. The selective, reconstructive vascular surgery does not have a considerably higher risk in the elderly. Depending on the localisation the mortality following revascularisation is considerably less with 3,3 to 21,1% than following the amputation of limbs with 42,5%. A further reduction in the rate of complications after reconstruction is possible due to extra-anatomical procedures and early diagnoses before irreversible damage occurs. The possibility of revascularisation should be tested in good time, particularly in elderly persons with disturbed circulation and especially before an amputation.