The authors report their experience with 55 intrapopliteal percutaneous transluminal angioplasty (PTA) procedures performed primarily for limb salvage between May 1986 and June 1992. Forty patients who underwent 55 PTA procedures were followed up prospectively. Multiple risk factors were present in 41 cases (75%). Twenty-three procedures were performed in patients with distal saphenous vein (n = 7) and femoropopliteal (n = 16 [13 were polytetrafluoroethylene]) bypass grafts. Follow-up was available for 54 of the 55 episodes. Technical success was achieved in 52 procedures (95%), with long-term clinical success in 23 of these 52 (44%) at an average follow-up of 25.8 months (range, 1–72 months). Failures tended to occur within the first 3 months. Of the eight PTA procedures in patients with distal saphenous vein bypass grafts, only two remained successes during the course of the study, at an average follow-up of only 2.5 months. Similarly, only two of 15 procedures performed in patients with femoropopliteal grafts remained successes. No complications resulted in emergency surgery or altered the original surgical reconstructive options. Infrapopliteal PTA is a safe and effective treatment for native vessel disease in selected patients facing surgical reconstruction for limb salvage but is less durable in patients who have undergone previous bypass procedures. © 1993, Society of Interventional Radiology. All rights reserved.