Aim: To evaluate the early and late results of thrombolysis in acute thrombotic ischaemia and graft occlusion. 
Patients and methods: In a prospective randomized study 40 patients with thrombotic ishaemia were divided into two 
groups. Group A :20 patients underwent thrombolytic therapy. Group B : 20 patients underwent surgical reconstruction . 
Results: Group A: Primary success in 17 patients (85%). 
Failure of thrombolysis in 3 patients (15%) Primary patency rate 85%. No mortality occurred during follow up. 
Group B: Primary success rate was 75 %(15 patients). In 3 patients with acute thrombosis amputation was performed, one due to secondary hemorrhage and ligation of the graft .and the other two were due to graft failure and gangrene during the first month postoperatively. Mortality occurred in 2 patients (10%) 
Conclusions: Thrombolysis as compared with immediate surgery reduces the number of open procedures required for acute ischemia of the lower limb & allows some patients to avoid surgical intervention.