The success of bypass grafts to the dorsalis pedias artery has been a major advance in preventing lower extremity major amputations in patients with diabetes mellitus. The vascular occlusive disease of diabetes tends to involve the infrapopliteal arteries, but there is relative sparing of the dorsalis pedis artery. In about 30% of patients with diabetes mellitus undergoing distal arterial reconstruction for limb salvage, the dorsalis pedis artery is the appropriate target vessel. In approximately 50% of those, it is possible to use the popliteal artery as the inflow source. This video demonstrates the technique of using a translocated (non-reversed) saphenous vein graft in the popliteal to dorsalis pedis configuration. The techniques of graft preparation, tunneling, anastomosis, and wound closure are described. Surprisingly, the results of bypass grafts to this distal target artery are very nearly equal to those of bypass grafts to more proximal target vessels including the popliteal artery, as in femoral-popliteal bypass. In spite of the almost universality of diabetes mellitus in these patients, along with associated complications, the operative mortality in over 1,000 procedures has been only 0.9%, with a five-year limb salvage of nearly 80%. Thus this is an operation for which there is an increasing need and at the same time it is safe and durable. Dorsalis pedis bypass should be in the skill set of all vascular surgeons taking care of patients with diabetes mellitus and lower extremity arterial disease.