Background The great saphenous vein (GSV) has long been recognized as a best conduit for vascular bypass procedures. Concomitant varicose veins disease may be a reason for GSV unavailability either due to dilatation and tortuosity of the vein or due to its destruction during invasive venous treatment. Aim - to assess the rate of varicose vein patients with concomitant lower extremity arterial disease (LEAD) who have previously lost their GSV due to venous ablation. Material and methods 285 patients (76 F, 209 M) with LEAD were consecutively enrolled. Demographic data and medical history were taken. Physical examination and duplex ultrasound were performed. We registered presence of varicose veins (VVs), type of previous invasive procedure and availability of saphenous veins as possible grafts. Results Mean age of screened LEAD patients was 70.5±9.1. 62 (21.75%) patients had varicose veins or were operated on before due to varicose veins. 42 patients with varicose veins had C2 disease, 10 had C3, nine had C4 and one had C6 according to CEAP classification. Duplex ultrasound examination of the veins of the lower extremities was performed on 111 patients (222 lower extremities). The total number of lower extremities without ipsilateral GSV was 76 (34.2%) due to varicosity, small size, previous ablation or postthrombotic intraluminal changes. 53 limbs in 32 patients had VVs. Despite the presence of varicose tributaries, the GSV was suitable for bypass in 9 lower extremities. GSV was not available as a conduit in 34 (20.1%) ipsilateral lower extremities in the LEAD group and in 42 (79.3%) ipsilateral lower extremities in the LEAD with VVs group (p= 0.0001). Varicose vein disease was associated with a higher frequency of the GSV unavailability odds ratio 18.8 (95% confidence interval 8.35 – 42.35). On the 11 ipsilateral limbs (5%) GSV was unavailable due to previous venous interventions. Conclusions Almost 20% of patients may have both LEAD and VVs. Among those with VVs, most have the ipsilateral GSV unavailable as a potential conduit. Additionally, one fifth of limbs with VVs had GSVs destroyed previously due to saphenous ablative procedures.