The number of amputations performed for vascular disease in Denmark has decreased from 1777 (34·5 per 100 000 population) in 1983 to 1288 (25·0 per 100 000) in 1990, a reduction of 28 per cent. This decline coincided with an increase in vascular surgical activity of up to 100 per cent, including a marked rise in the rate of femorodistal reconstruction. Moreover, regional variation in vascular surgical activity correlated with percentage reduction in amputation rate (rs = 0·65, P < 0·01). The relative number of above-knee amputations also decreased in favour of more distal levels during the period studied. These findings suggest that vascular surgery may be responsible for the lower amputation rate.