A considerable portion of the elderly have this experience, walking a distance after one or both sides of the calf pain, to be forced to stop, after a few moments of rest, the pain disappeared, but also continue to walk; the symptoms recur, to a distance to stop and rest several times. This symptom is often considered to be old legs and feet inconvenience, in fact, this is a sign of lower extremity atherosclerosis, medically referred to as intermittent claudication. Atherosclerosis of the lower extremities is a part of systemic atherosclerosis, which occurs when lipids in the blood are deposited under the endothelium of the arteries leading to the lower extremities, or when the smooth muscle cells under the endothelium proliferate, resulting in the endothelium protruding into the lumen, causing narrowing of the lumen and a decrease in the flow of blood to the lower extremities. As the lesion progresses, the lumen becomes narrower and narrower, and when the blood supply fails to meet the oxygen and nutrient needs of the limb during movement, symptoms will appear. Initially, the symptoms are coldness and numbness of the limbs, and the increased demand for oxygen by the muscles of the lower limbs when walking, while the diseased blood vessels are unable to provide enough oxygen-rich arterial blood, forcing the muscle cells to undergo anaerobic metabolism, which generates a large amount of acidic metabolic wastes, and in turn causes pain. When the activity stops, the metabolic waste is removed by the blood flow, the pain disappears, and the symptom is repeated. The distance from the start of walking to the point at which the pain forces the patient to stop is called the claudication distance. The claudication distance decreases as the lesion progresses. When stenosis or occlusion of the arterial trunk occurs, localized hypotension in the distal artery releases vasoactive substances, leading to dilatation of the small arteries of the collateral branches, which maintains nutritive blood flow by compensatory microvascular dilatation. The lesion progresses further, and when even collateral compensation is insufficient to maintain the needs of the limb, the portion of the toe with the poorest blood supply develops around-the-clock pain called rest pain. Eventually the limb becomes gangrenous. After the symptoms of intermittent claudication occur, the patient should be seen in the hospital as soon as possible. When the doctor examines the patient, he or she may find one or both limbs pulseless, with cold, purple or pale extremities. Depending on the patient’s condition, the doctor may recommend ultrasound, arterial segmental pressure measurement, magnetic resonance angiography or angiography. The first three are non-invasive tests. Ultrasound costs less, but its accuracy is related to the operator’s experience, and it cannot provide images that clinicians are familiar with; segmental manometry can be used for rough characterization and localization of the condition; magnetic resonance angiography can provide an overall image of the arteries, but its accuracy is inextricably linked to the function of the magnetic resonance machine and the operator’s experience; and angiography is the most accurate method, which is invasive and requires hospitalization, and the process of angiography is very simple. The most accurate method is angiography, which is invasive and requires hospitalization. During the procedure, an arterial puncture is made from the groin or upper limb, a catheter is inserted, and the catheter is placed in the artery for injection of contrast medium. 24 hours of bed rest is required for the lower limbs after the puncture, and the puncture site of upper limbs should be bandaged with pressure for 24 hours. The treatment of lower limb atherosclerosis includes internal conservative treatment and surgical treatment. Internal treatment is applicable to patients with mild disease or those who cannot tolerate surgery, including smoking cessation, warmth preservation, appropriate exercise, hyperbaric oxygen therapy, and various kinds of vasodilators, anticoagulants, blood thinning drugs and so on. Surgical treatment includes intervention and surgery. Interventional therapy is a minimally invasive treatment, under local anesthesia through the arterial puncture, the introduction of catheter, the narrow part of the expansion or stenting, the advantages of trauma is small, the patient’s recovery is fast, applicable to larger blood vessels, spring stent in recent years can even be used for narrow arteries near the knee joint. Interventional therapy is good but expensive and is not suitable for patients with long vascular lesions. Surgical treatments vary from patient to patient and include sclerotic endarterectomy and bypass grafting. Localized sclerosing endarterectomy can be used if the lesion is limited, otherwise bypass surgery is necessary. Autologous saphenous veins or artificial blood vessels are used to anastomose with normal arteries at each end of the stenotic occluded segment, thus supplying blood to the distal limb over the stenotic segment. Compared with interventional therapy, bypass surgery is more invasive and usually requires general or partial anesthesia, bed rest for 5-7 days after surgery, and sutures can be removed only after 2 weeks. Whether it is interventional or surgical treatment, there is a possibility of thrombosis and reembolization after the operation, so anticoagulation or antiplatelet therapy should be continued. Lower extremity atherosclerosis is generally segmental lesions, most of the conditions for bypass, but if the blockage time is too long, secondary thrombosis in the distal vessels, the opportunity for bypass will be lost, ultimately leading to amputation. Therefore, early diagnosis and early treatment are crucial.