Twenty-three patients who underwent renal revascularization with autogenous arterial bypass grafts for renovascular hypertension are reviewed. The arterial autograft consisted of the hypogastric artery in 19 cases and a free splenic artery graft in 4. Eighteen patients were cured (78 per cent), 4 improved (18 per cent) and there was 1 failure (4 per cent). There were no cases of graft stenosis or occlusion. Postoperative morbidity was minimal and there was no operative mortality. When such grafts are available they provide an excellent means to achieve successful long-term renal revascularization.