A considerable number of elderly people have this experience, walking for a period of time after the emergence of one or both side of the calf belly pain, so forced to stop, rest a few moments, the pain disappeared, but also can continue to walk; symptoms recur, so that a journey to stop several times to rest. This symptom is often considered to be the inconvenience of old age, but in fact it is a sign of atherosclerosis of the lower extremities, which in medical terms is called intermittent claudication. Lower extremity atherosclerosis is part of systemic atherosclerosis. When the lipid content of the blood is deposited under the intima of the arteries leading to the lower extremities, or when the smooth muscle cells under the intima proliferate, causing the intima to protrude into the lumen, the lumen is narrowed and the blood flow to the lower extremities is reduced. As the lesion progresses, the lumen becomes narrower and narrower, and when the blood supply cannot meet the demand for oxygen and nutrients during limb movement, symptoms will occur. Initially, the limb becomes cold and numb, and the oxygen demand of the lower limb muscles increases when walking, while the lesioned vessels cannot provide enough oxygen-rich arterial blood, forcing the muscle cells to undergo hypoxic metabolism, resulting in the production of large amounts of acidic metabolic wastes, which irritate the nerve endings and in turn cause pain. When the activity stops, the metabolic wastes are removed by blood flow and the pain disappears, a symptom that repeats itself. The distance between the start of walking and the onset of pain forcing the person to stop is called the claudication distance. As the lesion progresses the claudication distance is gradually reduced. When stenosis or occlusion of the arterial trunk occurs, local hypotension in the distal artery releases vasoactive substances, resulting in dilation of the small collateral arteries, which maintain nutritional blood flow by compensating for microvascular dilation. The lesion progresses further, and when the collateral compensations are also insufficient to maintain the needs of the limb, the part of the toe with the poorest blood supply experiences pain around the clock, called resting pain. Eventually gangrene develops in the extremity. Symptoms of intermittent claudication should be seen at the earliest possible time after they occur. Depending on the patient’s condition, the doctor may recommend ultrasonography, arterial segmental manometry, MRI angiography, CT angiography or angiography. The first three are non-invasive tests. Ultrasound is less expensive, but its accuracy is dependent on the operator’s experience and does not provide images familiar to the clinician; segmental manometry can be used for rough characterization and localization of the condition; MRI provides an overall image of the artery, but its accuracy is dependent on the capabilities of the MRI machine and the operator’s experience; CT angiography is rapid and accurate, but requires x-ray exposure and contrast. The most accurate method is angiography, which is invasive and requires hospitalization. During the imaging process, an arterial puncture is performed from the groin or upper extremity, a catheter is inserted, and the catheter is placed in the artery to inject the contrast agent. The treatment of lower extremity atherosclerosis includes conservative medical treatment and surgical treatment. Medical treatment is suitable for patients with mild disease or those who cannot tolerate surgery, including smoking cessation, warmth, appropriate exercise, hyperbaric oxygen therapy, and various vasodilating, anticoagulant, and blood-vitalizing drugs. Surgical treatment includes both interventional treatment and surgical treatment. Interventional therapy is a minimally invasive treatment modality, in which a catheter is introduced through arterial puncture under local anesthesia and the stenosis is dilated and/or stented. In the past, it was thought that interventional treatment was not applicable to patients with long segmental vascular lesions, but with the innovation of interventional devices and the popularity of interventional techniques, almost all lower extremity arterial lesions can now be addressed by interventional techniques. Surgical treatment varies from person to person and is mainly of two types: sclerosing endothelial debridement and bypass grafting. If the lesion is limited, local sclerosing endothelial debridement can be used; otherwise, bypass surgery is required. An autologous saphenous vein or an artificial vessel is used to anastomose with a normal artery at each end of the stenotic occluded segment, thus supplying blood to the distal limb across the stenotic segment. Compared to interventional treatment, bypass surgery is more traumatic and involves greater blood loss, usually requiring general or semi-body anesthesia, and requires 5-7 days of bed rest and 2 weeks for stitch removal. Whether it is interventional or surgical treatment, there is a possibility of thrombosis and re-embolization after surgery, so anticoagulation or antiplatelet therapy should be continued. Interventional surgery is not only minimally invasive, but can be repeated when the lesion recurs; surgical open surgery can also be operated on again, but the difficulty is greatly increased during the second operation, and the number of possible problems increases. With the popularization of technology and advancement of equipment, surgical procedures have been gradually replaced by minimally invasive interventional procedures. Lower extremity atherosclerosis is usually a segmental lesion, and most of them have conditions for intervention or bypass, but if the blockage is too long and secondary thrombosis occurs in the distal vessels, the opportunity for treatment will be lost, which will eventually lead to amputation. Therefore, early diagnosis and early treatment are crucial.