83-year-old male, Type I Diabetes, end stage renal disease, living independently who was told he needed a below knee amputation. The patient had a failed popliteal to dorsalis pedis artery bypass graft. An attempt at endovascular repair also failed. The patient came for a second opinion. A second at endovascular repair was successful. The patient had a transmetarsal amputation which healed. He continued to live on his own for another 4 years, enjoying his life with both legs.