In situ saphenous vein bypass is a technique of lower-extremity revascularization that is gaining popularity as an alternative to the reversed saphenous vein graft. In the latter, the saphenous vein is removed from its bed and reversed before arterial anastomosis. The former uses the vein in situ after the venous valves are made incompetent and the perforators are ligated. Only the proximal and distal ends of the vein are mobilized for anastomosis. The radiologist assists in the management of these patients by performing preoperative venography, intraoperative arteriography, and postoperative arteriography when required. Techniques of these procedures, along with normal and abnormal findings, are discussed.