The 45 patients with popliteal artery aneurysms have been treated at the Institute for Cardiovascular Diseases from Belgrade, during the last 36 years. Four of them were women and 41 men, with average age of 61 years. The incidence of bilateral localization was 28%. The aneurysms have been presented with the rupture in 6 cases, with deep popliteal venous thrombosis in 3 cases, with sciatic nerve compression in one case, and with acute or chronic leg ischemia in 38 cases. Seven small asymptomatic aneurysms have not been operated. The primary major leg amputation had to be done in 8 cases due to irreversible ischemic changes. Any form of reconstructive procedures has been done in 48 cases (total or partial aneurysmal resection with graft interposition, an aneurysmal exclusion and bypass procedures). The autologous saphenous vein graft has been used in 42 cases, PTFE in 5 cases and Bovin solco graft in one case. Three patient died intraoperatively due to massive myocardial infarction. The early patency rate was 91%, and limb salvage 93%. The follow-up period was between 2 months to 16 years (men 3 years). The long term patency rate was 86%, and limb salvage 97%. The surgical treatment is the method of choice in case of popliteal artery aneurysm, due to good results, and possible complications.