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¹National Institute of Mental Health and Neurosciences (NIMHANS), Department of Neurosurgery, Bangalore, Karnataka, India DOI : 10.5137/1019-5149.JTN.22636-18.2 In macrosurgery creating a knot with at least three throws is an established practice. The potential disadvantages of this practice in microsurgery include the following: the direction of the cut ends interfere with the suture line, unbalanced nature of knot disturbs the apposition of delicate vessel ends and the excessive knot weight. A reef knot with only 2 throws may thus be a better alternative. We have described our technique of end to end anastomosis with 2-throw reef knots in a rat femoral artery model using one way up method. Judging from the surgical outcome the practice of two throw reef knot seems feasible and appealing. Keywords : Throws, Reef knot, Microvascular anastomosis