Diabetic foot syndrome is one of the most serious complications of diabetes. Treatment of its purulent-necrotic manifestations is often associated with a risk of neurovascular bundles traumatization on foot. 130 anatomical specimens of adult feet and 210 angiograms of the lower extremities vessels with variant anatomy of tibial arteries were studied in order to found out the optimal minimally invasive access for treating complications of diabetic foot syndrome. It was established that the architectonics and topography of the arteries which form foot vascular net (rear, lateral and medial plantar) were characterized by a wide range of variant anatomy and different degree of development of intersystem anastomoses. It is demonstrated that variant anatomy of foot arteries determines the compensatory possibilities of tissues in vascularization of occlusive arterial lesions. The variant with the predominant development of the lateral plantar artery or with the same development of both plantar arteries and well-developed anastomoses with the posterior artery are the most favorable.