Tumescent local anesthesia (TLA), originally developed for liposuction, has found widespread application. We report a case of peripheral arterial bypass grafting under TLA. The patient was an 84-year-old female diagnosed as having coronary subclavian steal syndrome caused by proximal left subclavian artery stenosis. Because she had several risk factors for general anesthesia, we performed axilloaxillary artery bypass grafting under TLA and mild sedation. There was no morbidity related to the surgery. The TLA technique may be ideal for performing peripheral arterial bypass grafting if general anesthesia is inappropriate because of cardiac complications.