In the past few years, rates of the lower extremity amputations for ischemia have been decreasing in some countries and many world regions. Surely, growing numbers of revascularization procedures contribute to the situation. In the Czech Republic, the amputation and large amputation rates are similar to those in the developed countries (45, resp. 24/100 000) (according to hospital data), as well as the numbers of surgical revascularizations. However, in our country, foot amputations are on increase, while numbers of major amputations do not decrease, probably as a result of the human age prolongation and fast increase of diabetes mellitus rates. The following prerequisites are required to improve the situation: primary prevention of atherosclerosis, building a network of vascular centres which are able to provide all modern revascularization methods. In cooperation with general practitioners, angiologists, diabetologists and other medical specialists, it is necessary to prevent most patients from developing critical extremity ischemia. If it develops, it should be diagnosed immediately and the revascularization procedure should be considered.