Objective: To evaluate the long-term efficacy of surgical therapy for popliteal artery entrapment syndrome (PAES), and improve the treatment experience. Methods: The clinical and follow-up data of 6 PAES patients treated in Department of Vascular Surgery of Peking University People’s Hospital between July 2002 and March 2009 were retrospectively analyzed. Results: Of the 6 patients, 5 cases were male and one case was female, and age ranged from 16 to 56 (average 28) years; 4 cases were popliteal artery occlusion and 2 cases were popliteal artery stenosis with post-stenotic aneurysm formation; 3 cases underwent myotomy of the anatomically abnormal muscular structure and revascularization (partial resection of the aneurysmal wall and arterioplasty in one case, partial resection of the aneurysmal wall with saphenous vein patch plasty in one case, and popliteal endarterectomy in one case, respectively) through posterior S-shaped incision in the popliteal fossa; 3 cases underwent bypass surgery with the autologous great saphenous vein without popliteal fossa exploration. Follow-up was conducted for 64 to 144 (average 110.8) months, during which time, the symptoms in all 6 patients were alleviated, and no complications such as nerve injury or gangrene occurred; no recurrent intermittent claudication was found in 5 cases and their native popliteal arteries or bypasses were patent; bypass graft occlusion was found in one patient with recurrent intermittent claudication presenting in the clinic at postoperative 49 and 51 months respectively, and it was recanalized by catheter directed thrombolysis and then underwent conservative treatment. The 1- and 5 year primary patency rate was 100.0% (6/6) and 83.0% (5/6), respectively. Conclusion: Surgical treatment is effective for PAES, and also offers a long-term patency rate. In situ revascularization via a posterior approach should be considered as first choice if the situation permits.