The most common disorder with bilateral lower extremity numbness is multiple peripheral neuropathies. Peripheral neuropathy has multiple etiologies, the common ones being ischemic and inflammatory. Elderly patients with a long history of hypertension or with diabetes mellitus or hyperlipidemia often have atherosclerosis of the lower extremities, resulting in poor peripheral vascular blood supply and causing neurotrophic impairment with garter-like hyperalgesia, manifested as hyperalgesia with pinprick pain below both knees, and also with deep sensory disturbances. Inflammatory polyneuropathy is associated with autoimmunity, with viral infections or paraneoplastic syndromes and other causes, and can start with numbness in both lower extremities or in all four limbs. Refinement of nerve conduction velocity and electromyography suggests peripheral nerve injury in both lower extremities as well as neurogenic damage.