Introduction: Since James Syme described his amputation at the ankle joint (1842), there were progonists and opponents to it. Most authors agreed that Syme’s Amputation should not be considered for patients with Diabetic Vascular Disease (DVD). Patients and Methods: We describe the results of 70 patients who underwent Syme’s Amputation between the years 1980–2000 in our department. Fifty-one of the patients had Syme’s Amputation due to Diabetic Vascular Disease. The other 19 patients had their Syme’s Amputation due to other reasons (i.e. trauma, malignancy, congenital). Results: The 19 patients of the non-DVD group had success rate of 94.7% (18/19). The overall success rate of the DVD patients was 49% (25/51). When we analysed the DVD group by age, the cut point was 65 years old. Patients under the age of 65 (including) had success rate of 68.2% (15/22) and over the age of 65 30.8% (8/26). The cause (disease) is the leading factor in predicting the success. If the patient has DVD, there is 18.5 fold (odd ratio) to fail a Syme’s Amputation. The age is the second in significance for success in Syme’s Amputation. For each decade aging, there is 1.96, (odd ratio) fold chance to fail a Syme’s Amputation. Conclusions: Patients sustaining DVD should be considered as good candidates for Syme’s Amputation if they are younger than 65 years old.