The number of chronic limb-threatening ischaemia (CLTI) among arteriosclerosis obliterans tends to increase because of an aging, prevalence of diabetes mellitus and increased chronic kidney disease stage. The Bypass versus Angioplasty in Severe Ischaemia of the Leg (BASIL) trial was reported in 2005. After that, together with evolution of endovascular therapy (EVT), surgery has been considered if patients with CLTI have a life expectancy of more than two years and have an appropriate saphenous vein. On the other hand, EVT has been considered as the first-choice treatment of CLTI patients with a life expectancy of less than two years. However, currently treatment of CLTI has been changed dramatically. In the 2017 European Society for Vascular Surgery (ESVS) / ESC Guidelines, the Society for Vascular Surgery (SVS) Wound, Ischemia, and foot Infection (WIfI) classification was added and autologous vein bypass was described for patients with CLTI class I. A new Global Vascular Guideline will be published in September 2018, in which it is recommended that treatment of CLTI is systemically selected based on the severity of systemic disease, wound severity and anatomical severity. In Japan, unlike other countries, chronic renal failure, especially maintenance dialysis patients often have concurrent CLTI, for which physicians commonly have difficulties in selecting a treatment strategy in the real clinical circumstances. Considering these background, we would like ask the enthusiastic Japanese physicians involved in active intervention in management of CLTI to participate in the meeting, and to give a presentation on current multidisciplinary therapy for CLTI along with the modified guidelines.