Amputation is most frightening for patients with ischemic gangrene of the arteries in the lower extremities. So, must a severe gangrene of the lower extremity be amputated? Ischemic gangrene of the arteries of the lower extremities is usually combined with a more serious bacterial infection. This infection causes gangrene of the tissues, and because of the combination with blood flow disorders, it makes infection control very difficult and gangrene healing is very unlikely, even with the use of highly sensitive antibiotics. Also, this bacterial infection of the affected limb poses a great risk of infection for revascularization surgery, which may result in systemic dissemination of bacteria and more surgical complications after restoration of blood flow. Therefore, for affected limbs with lower limb arterial ischemia with severe ischemia, amputation should be considered for treatment. However, the latest technology of leg preservation for severe ischemia of the lower limb by interposition of artificial vessel saphenous vein arterialization pioneered by modern high medical science has overcome this problem. So for those patients with severe gangrene of the lower limbs, they can greatly put their minds at ease.