Between September 1995 and February 1996 we attempted to perform video-assisted aortofemoral bypass in nine patients. All patients were male with a mean age of 58.7 years, mean weight of 64.7 kg, and mean height of 1.69 m. In two patients it was necessary to switch to open laparotomy due to inadequate aortic exposure in one and extensive aortic calcification in the other. Aortobifemoral bypass was performed by the transperitoneal approach in three patients and unilateral aortofemoral bypass by the retroperitoneal approach in four patients. Exposure was more difficult by the transperitoneal approach. Postoperative graft patency was excellent in all patients. Video-assisted surgery did not shorten the delay to resumption of intestinal transit but it did reduce the duration of hospitalization and need for postoperative analgesia. Our experience suggests that video-assisted aortofemoral bypass without laparotomy can be performed and that it allows more rapid patient recovery.