This video will review technique, equipment and results with intraoperative angioscopy in 45 lower limb revascularization procedures (22 femoro-distal, 12 femoro-popliteal bypasses, five extra-anatomic procedures and six embolectomies/ thrombectomies). Our results will demonstrate the usefulness of angioscopy in a) intraoperative surgical decision-making; b) as an aid in intra-arterial therapeutic manipulation; c) in clinico-pathological correlation and d) as an adjunct or alternative to the intraoperative angiogram; and, show that angioscopy is cost-effective, reducing both patient morbidity and OR time.