Femoral-to-popliteal/distal bypass surgery is a procedure used to treat femoral artery disease. It is performed to bypass the narrowed or blocked portion of the main artery of the leg, redirecting blood through either a transplanted healthy blood vessel or through a man-made graft material. This vessel or graft is sewn above and below the diseased artery such that blood flows through the new vessel or graft. The bypass material used can be either the great saphenous vein from the same leg or a synthetic polytetrafluoroethylene (PTFE) or Dacron graft. Blockage is due to atherosclerosis that causes peripheral vascular disease. This procedure is recommended for patients with peripheral vascular disease for whom medical management has not improved symptoms, for those with leg pain at rest that interferes with quality of life and ability to work, for non-healing wounds, and for infections or gangrene of the leg where there is a danger of loss of limb caused by decreased blood flow. Here we demonstrate how to perform femoral artery cut-down and proximal anastomosis procedure in a cadaver. This procedure is commonly used when performing a femoral-popliteal below the knee bypass to restore blood flow to areas affected by arterial blockages or injuries․