Background: Foot ulcer is a disabling complication and not uncommon among patients with DM, the predictive factors for diabetic foot ulcer development were peripheral neuropathy, duration of diabetes, poor glycemic control, and peripheral vascular disease which was a major significant risk factor. Aim of the study: to determine whether Reversed or Insitu Great Saphenous Vein Grafts is the optimum In Infrapopliteal Revascularization. Patients and Methods: diabetic patients referred to Vascular Surgery department of Al-Azhar University Hospitals and Nasr City Hospital were included if they had foot lesions such as ulcers, gangrene or tissue necrosis and had no palpable pedal pulses. End points were healed, healing, non healing or amputation. Fifty diabetic foot patients were included. Results: twenty-four patients reached the end point of adequate healing or complete healing, whereas twenty-six patients had nonhealing lesions. The Ankle Peak Systolic Velocity (APSV) was significantly higher in patients with Reversed Great Saphenous Vein Grafts compared with patients with Insitu Great Saphenous Vein Grafts: 57.8cm/s (±12.72) versus 24.9 cm/s (±9.55), p < 0.001. At a cutoff point of 40 cm/s, the APSV showed sensitivity of 90.91%, specificity of 100%, positive predictive value of 100%, negative predictive value of 92.3%, with diagnostic accuracy of 97.4% in predicting healing of diabetic foot lesions. There was a significant difference between the APSV before and after revascularization: 23.4 cm/s (±6.5) versus 58.8 cm/s (±12.3), p < 0.001. Conclusion: both reversed and insitu great saphenous vein grafts have good patency in infrapopliteal revascularization.