Arteriography, which requires resources and is not entirely without risk, has hitherto been a prerequisite for reconstructive surgery in cases of symptom-producing arteriosclerosis in the lower limbs. As an alternative, indirect Doppler ultrasonic examination has been employed but does not appear to be suitable in the clinical routine. On the basis of a review of the literature, it is suggested that, employing a combination of ultrasonic picture scanning and Doppler ultrasonic duplex scanning, it may be possible to diagnose significant solitary stenoses or short occlusions in the aorto-iliac segment and in the femoral artery but that this does not appear to be employable at present in cases of multiple lesions. Examination of the popliteal artery is still too unreliable and reasonably certain assessment of the crural arteries is not possible with the present technique. Duplex scanning can thus not replace arteriography as yet for examination of patients with ischaemia in the lower limbs.