A 59-year-old man was referred to our department for the treatment of cellulitis and skin necrosis after a bruise of the left lower leg. He had suffered from intermittent claudication of the left calf for a year and arterial pulses in the left lower limb were absent. Arteriogram showed hypoplasty of the left external iliac artery and aplasty of the left superficial femoral artery. A persistent sciatic artery was noted to be the dominant blood supply to the left lower extremity. Left ilio-popliteal artery bypass using 6mm ringed ePTFE graft was performed. After arterial reconstruction, skin transplantation was performed and the intermittent claudication disappeared completely.