Aim of the study. Aim of the study was to analyze the outcomes of surgical treatment of acute thrombosis of the popliteal-tibial segment arteries with various etiological factors of its occurrence. The analysis of the surgical treatment of 40 patients with acute thrombosis of the popliteal-tibial segment arteries was carried out for the period from 2014 to 2020. Depending on the pathogenesis of acute thrombosis of the popliteal-tibial segment arteries, the patients were divided into three groups: Group 1 – 17 (42.5%) patients with acute arterial thrombosis of the popliteal-tibial segment caused by embolism or thrombosis in the background of stenotic-occlusive diseases of the lower extremitiesvessels; Group 2 – 15 (37.5%) patients with acute arterial thrombosis of the popliteal-tibial segment in the background of thromboangiitisobliterans of the lower extremities (Buerger's disease); Group 3 – 8 (20%) patients with acute arterial thrombosis of the popliteal-tibial segment in the background of popliteal artery aneurysm. During the follow-up period of 2 months, the incidence of rethrombosis and amputation of the lower limb in the patients of Group A was 5.9% and 5.9%, respectively. In Group B, the incidence of rethrombosis and amputation of the lower limb was 73.3% and 40.0%, respectively. In group C, the incidence of rethrombosis and amputation of the lower limb was 12.5% and 12.5%, respectively. Conclusions. In patients with acute arterial thrombosis of the popliteal-tibial segment in the background of embolism or stenotic-occlusive diseases, combined endovascular or hybrid surgical interventions showed better results compared to open thrombectomy, in which rethrombosis was diagnosed in 14.3% of cases. In patients with thromboangiitis obliterans of the lower extremities, regional catheter-directed thrombolysis showed better (p=0,04) results compared to open thrombectomy and endovascular interventions, in which rethrombosis was diagnosed in 90% and 100% of cases, respectively. In patients with popliteal artery aneurysm, open surgical interventions or regional catheter-directed thrombolysis showed better results compared to endovascular interventions, in which rethrombosis was diagnosed in 50% of cases.