Objective To treat ischemia of the lower extremity, endarterectomy was performed. Methods In 22 patients with arterial occlusive disease, arteriotomy was performed at the distal end of the occlusive part. Artheroma was freed and cut off. A ring stripper was inserted into the artery and went up to the proximal end of the occlusive lesion. The artheroma was removed by a Fogarty through arteriotomy. The distal end of the cut intima was sutured to the arterial wall. Results The removed occlusive lesion was 10 to 43 cm long. Symptoms disappeared in 19 patients (86.4%), and no deaths occurred. Endarterectomy failed in one patient and a bypass was performed with the reversed suphenous vein. Amputation was performed in two patients because of its insufficient run-off. The average time of follow up was 3.2 years, and patients with arterial thrombosis were treated by thrombolytic therapy. Two patients with artery stenosis were cared by vein patch angioplasty. One experienced rest pain after treatment with a long-term patency 68.2%. Conclusions Endarterectomy is still a choice of treatment for ischemia of the lower extremity, and it is simple and its patency is similar to that of arterial bypass.