Purpose:Early bypass graft failure(EGF), occlusion of bypass graft within 30 days of index procedure, is associated with significant mortality and morbidity in infrainguinal arterial reconstruction surgeries. We aim to identify predictors of EGF in contemporary Australian-New Zealand vascular surgical practice. Methodology:Data from the Australasian Vascular Audit by the Australian and New Zealand Society for Vascular Surgery were retrospectively reviewed. Patients who underwent infrainguinal bypass from 2013 to 2022 were selected from the database. Demographics, operative details and relevant associations were analysed by multivariate logistic regression. The primary endpoint was graft failure within 30 days. Results:A total of 18,684 open infrainguinal arterial bypasses were performed, 1,121(6%) were complicated by EGFs. 13,922 were male with mean age 69+/-12 years. Comorbidities included hypertension(86%), smoking(72%), ischaemic heart disease(54%), diabetes(36%) and significant renal impairment(8%). Indications for initial bypass included tissue loss(31%), claudication(27%) and rest pain(17%). Significant predictors of EGF included end-stage renal failure (Odds Ratio[OR],19.4; p=<.001), pedal bypass (OR, 4.1; p=.026), use of prosthetic graft (OR,1.8; p=.001), in-situ great saphenous vein (OR,1.5; p=.011), and suboptimal venous conduit (OR,3.0; p<.001). Although the proximal anastomotic site and blind popliteal run-off displayed associations with graft failure, they were not significant in our regression model. Hypertension (OR, 0.8; p=.025), ischaemic heart disease (OR, 0.8; p=.003), having three vessels run-off (OR,0.7; p=.003) and utilising reversed GSV conduit (OR,0.7, p=.03) were protective factors against EGF. Conclusion:Our study revealed similar rate of EGF compared to existing literatures, and identified multiple non-technical factors that contributed to higher failure rate. Consideration of risk factors in operative planning may improve graft prognosis.