Objective – to improve the results of surgical treatment of patients with combined lesions of carotid arteries and lower extremiy arteries. Materials and Methods. It was perfomed the prospective analysis of 220 patients with combined atherosclerotic lesions of carotid and lower extremity arteries. Тhe patients were divided into two groups by random sampling. In the first group surgical intervention was carried out according to proposed algorithm, in the second group - according to standard technique. Results. Over a two-year observation period, the late postoperative mortality was as follows: in group 1 – 5.2%, in group 2 – 9.4%. Over a five-year observation period, in group 1 – 10.5%, in group 2 – 18.8%. The overall mortality over 2 years was 7.1%. Over 5 years – 14.2%. Сonclusion. When appropriately indicated and with thorough preoperative preparation, single-stage surgeries can be per formed with good results. The role of coronary angiography has been established in preventing the development of cardiovascular events. An algorithm for diagnosis and the selection of the sequence of surgical interventions on the carotid arteries and arteries of the lower extremities has been proposed.