The outcome in 299 patients having 321 percutaneous transluminal angioplasty (PTA) procedures for peripheral vascular disease was analysed. Technical failure occurred in 21 patients (7%) but in none was the limb ischemia made worse by the failed PTA attempt; nine of these (3%) had been considered unsuitable for arterial reconstruction and proceeded to primary amputation, while 12 (4%) did not have subsequent management compromised by the failed PTA attempt. Complications occurred in seven patients (2.3%); four of these (1.3%) had worsening ischemia but were able to be satisfactorily managed by surgical intervention. There were 71 patients (23.7%) who had an initially successful PTA procedure which subsequently failed; 20 of these (6.7%) had been considered unsuitable for arterial reconstruction and proceeded to amputation, while five patients suitable for arterial reconstruction (1.7%) came to amputation, four following failed bypass surgery and one following multiple trauma from a motor vehicle accident. The remaining 46 patients (15.3%) did not have subsequent management compromised by the late failure of PTA. Early and late failure of PTA in patients presenting with peripheral vascular disease does not compromise subsequent management.