A total of 572 patients were treated 628 times for acute peripheral vascular occlusion. Arterial embolism was most frequent with 65% followed by arterial thrombosis and traumatic vascular occlusion. For differential diagnosis other causes had to be considered. The method of choice is extraction of the thrombus by Fogarty catheter or ring stripper. The results depend on the time between occurrence and operative treatment of the occlusion. Angiography is not necessary in a clear case of embolism, but essential when exact preoperative classification of the vascular occlusion is not possible.