Purpose: To demonstrate the feasibility of venous reconstructions with the superficial femoral-popliteal vein (SFPV). Methods: Seven patients who underwent a variety of major venous reconstructions using SFPV were reviewed in a retrospective, observational study. Results: Three central venous reconstructions (thoracic and abdominal) and four peripheral major venous reconstructions were performed with SFPV autografts. In all patients, the SFPV grafts provided an excellent size match and were of adequate length without the need for enlargement by paneling or spiraling techniques. Postoperative anticoagulation medication was not used. There were no early graft failures, and patency was documented by duplex ultrasound, venogram, or both in all patients at a mean of 20 months follow-up. Venous thromboembolism has not occurred, and lower extremity venous morbidity has been minimal. Conclusions: The SFPV graft demonstrates versatility and durability in selected patients who require large-caliber conduits for venous reconstruction. Because of its size and availability, the SFPV is an excellent conduit for major venous reconstruction.