A 58-year-old man was admitted to our hospital suffering from intermittent claudication and angiogram revealed complete obstruction of the left common iliac artery. The essential thrombocythemia was diagnosed from platelet count over 1,000,000/mm3 as well as bone marrow finding. After the platelet count was reduced into normal range by administration of ranimustine (MCNC), abdominal aorta-femoral artery bypass grafting using 8mm-diameter Gelseal graft was successfully performed without any complications such as thrombus formation or bleeding. Coldness and cyanotic discoloration of the lower extremities were diminished with the decrease in platelet count. He was discharged in satisfactory condition and has been on postoperative control with warfarin, ticlopidine chloride and aspirin therapy.