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The experience of management of popliteal artery aneurysms (PAA) in a provincial centre is described.Patients were identified from vascular audit, and case notes were reviewed retrospectively.There were 17 patients with 23 PAA over 12 years. All patients were male, with a mean age of 73 years. Other aneurysms were present in 77% of patients, 59% had bilateral PAA and 41% had an associated abdominal aortic aneurysm (AAA). Mean follow-up was 3 years, 3 months (range, 1 month-7 years). There were 11 acute procedures, and 12 elective. Reconstruction with bypass and ligation of the aneurysm was performed in all elective and 9/11 acute procedures. Of the 21 bypass procedures, 17 used autologous vein, three used GoreTex, and 1 composite graft. There were two PAA that were not reconstructable. All the vein grafts remained patent during the time of follow-up, but two of the three GoreTex grafts failed. Succesful reconstruction was achieved in 11/12 elective and 9/11 acute cases. All grafts in the acute group remained patent during the time of follow-up (mean, 3.5 years), in the elective group 11/12 grafts (91%) remained patent (mean follow-up, 2.5 years).An excellent outcome was achieved in both elective and acute procedures. Autologous vein grafts appear to give better results than synthetic grafts. Due to the high incidence of multiple aneurysms, screening for other aneurysms is suggested.