Introduction: Femoropopliteal bypass with vein conduit is a well-described and studied method of revascularisation since its inception in 1948. Over time, various techniques have evolved regarding the selection of vein conduit and configuration. There is limited data in Australia on the efficacy of reversed vs non-reversed and in-situ vein bypasses. Aims: A 5-year retrospective cohort study was conducted at a single institution to investigate whether reversed vein bypasses have a higher rate of stenosis at the proximal anastomosis due to size mismatch. Our secondary aims include long-term outcomes - re-intervention rates, graft patency, graft failure and major amputation. Methods: All patients who had an infra-inguinal bypass at Alfred Health between 2010 and 2015 were identified with reference to the AVA database. Patients who received single vein grafts were included. We investigated at 7-year follow up interval. Proximal stenosis was assessed using US. Results: 239 patients underwent infra-inguinal bypass surgery in our institution in a 5 year period. Our initial analysis of 62 cases in our study cohorts demonstrates a male predominance (2:1) with a Median age of 72 years. CLTI was the most common indication for intervention in both groups. 74% were reversed cephalic vein bypasses vs 24% non-reversed. Duplex arterial ultrasound was the predominant follow up modality. 6 week duplex arterial ultrasound demonstrated a haemodynamically significant proximal stenosis in 12% of all bypasses, of these 62% in the reversed bypass group. Conclusion: Reversed femoropopliteal bypass grafts demonstrates a higher rate of proximal stenosis at the initial surveillance study compared to non-reversed or in-situ bypass grafts. This may have implications regarding re-intervention rates and long-term patency. Further analysis will be conducted to rates of proximal bypass graft stenoses at intervals during the 7 year follow-up. Furthermore, studies with greater power are required to conduct multivariate analysis testing.