In severely ischaemic lower limbs, the skin response to changing posture from lying to standing is a diagnostic flush. We investigated this observation by measurements of the microcirculation using the non-invasive laser Doppler technique. Eleven patients with ankle: brachial pressure (A:B) ratios less than 0.7 were compared with 13 age-matched controls (A:B ratios greater than 1). In normal subjects, mean horizontal skin blood flow (SBF) was 30.2 +/- 14.9 (+/- SD), significantly greater than mean SBF in the ischaemic group: 12.4 +/- 9.2 (P less than 0.01, Student's t test). Mean SBF fell in the normal group on dependency to 27.5 +/- 16.4 but this change was not significant. Unexpectedly mean SBF rose in the ischaemic limbs to 20.7 +/- 13.8 (P less than 0.05). The pattern of SBF response to change in posture is different in normal and arteriopathic limbs.