Fifteen patients with lower limb ischemic disease were preoperatively assessed with both intravenous or intra-arterial digital subtraction angiography (DSA), and standard contrast angiography (SCA). The images were reviewed and the operative strategies, based on the clinical data and each of SCA and DSA, were compared. SCA provided more information than DSA in two patients, one of which had an incomplete DSA investigation. DSA provided more information than SCA in three patients. The distal crural vessels were better visualized with DSA in one patient, and popliteal lesions were demonstrated as being more severe using DSA than with SCA in two patients. The level of the distal anastomosis of the proposed bypass was lowered to below the knee as a result of DSA in these two patients. We conclude that comparable information is obtained using SCA or DSA, and that DSA, in particular the intraarterial technique, is a satisfactory alternative to SCA in preoperative evaluation of patients with lower limb ischemic disease.