1. Thirty-one patients with bilateral below-the-knee amputations who were fifty years of age or older at the time of their second amputation were studied. All had been ambulatory either as a unilateral amputee prior to the second amputation or as a non-amputee just prior to the simultaneous loss of both limbs. The average age at the time of the second or bilateral amputation was 58.1 years.
2. Of the twenty-seven patients who had been unilateral amputees secondary to vascular disease, twenty had lost their second limb within two years and seven had lost their second limb by six years after amputation of the first one.
3. Thirty of the thirty-one bilateral below-the-knee amputees became functionally ambulatory on their prostheses. The average follow-up period was three and one-half years, and the average age at follow-up was sixty-one years.
4. The high degree of successful rehabilitation which can be achieved in the older patient with bilateral below-the-knee amputations is a compelling reason for making every effort to amputate below the knee in the dysvascular patient.