INTRODUCTION: Surgical procedures on large arteries are associated with an increased likelihood of complications and a long rehabilitation period, making it extremely important to reduce the risks of such operations. The study aims to examine various aspects of preventing complications of surgical treatment, including preoperative preparation, intraoperative management, postoperative observation, and analysis of factors that determine treatment outcomes. METHODS: The present study used clinical data from 300 patients undergoing surgical treatment of aortoiliac segment occlusion to evaluate the effectiveness of preoperative correction. The study was conducted over 3 ys, from 2018 to 2023, at the university clinic of the nonprofit joint-stock company Semey Medical University. RESULTS: The study found that preoperative optimization, including medical correction of diabetes mellitus and chronic obstructive pulmonary disease, led to improved functional performance in patients. In the group of patients who underwent preoperative correction, intraoperative complications were recorded in only 12% of patients, while in the control group, where such correction was not performed, this figure reached 24%. A similar trend was observed concerning postoperative complications: 18% compared to 34% in the control group. CONCLUSIONS: Multiple logistic analyses confirmed the critical role of diabetes mellitus and chronic obstructive pulmonary disease as risk factors for postoperative complications, emphasizing the need to address these conditions before surgery. The practical significance of the study is to confirm the need for preoperative drug correction to reduce the risk of intraoperative and postoperative complications and improve the outcomes of surgical treatment of aortoiliac segment occlusion.