Background: Peripheral arterial aneurysms pose a serious threat to the affected limb. Debate continues about the best 
form of treatment especially for asymptomatic lesions. 
Patients and methods: 66 patients with peripheral arterial aneurysms presented to Mansoura vascular surgery unit from July 1998 to April 2002 . All patients were admited and subjected to clinical examination confirmed by investigations. 
Results: 66 patients (45 males& 21 females) presented with (18 femoral aneurysms), (15 popliteal aneurysms), (5 subclavian aneurysms), (2 ulnar artery aneurysms), (2 ATA aneurysms), (2 axillary and brachial artery aneurysms),and 22 anastomotic aneurysms. The commonest type of aneurysms were anastomotic, then femoral and popliteal aneurysms. Most cases were presented with complications (70%) like acute and chronic ischaemia, bleeding, D.V.T.,or neurological manifestation while, early non complicated cases represented (30%). Aneurysmectomy with end to end anastomosis were done in 6 cases. Closure of the defect in the areterial wall was done in 4 cases of pseudoarterial aneurysms. Ligation of aneurysms with arterial by pass using autogenous vein graft were done in 21 cases, ligation of aneurysms with arterial by pass using synthetic graft in 18 cases. Ligation of arterial ends after aneurysmectomy without reconstruction of arterial continuty were done in 17 cases. 
No operative mortality was found but one case died due to myocardial infarction in postoperative period. 4 cases did above knee amputation due to late presentation with thrombosed aneurysms with limb salvage rate 94%. 
Conclusion: Prophylactic surgical treatment of asymptomatic peripheral arterial aneurysms may avoid complications 
caused by thrombosis and embolisation of runoff, and so, elective surgical repair of peripheral aneurysms is safe, effective and durable technique without significant postoperative complications.