Seventy-three women requiring aortoiliac reconstruction for atherosclerotic occlusive disease were reviewed to determine the frequency of blood groups, lipid status and associated cardiovascular risk factors. These women demonstrated an increased frequency of blood group A (48% versus 36% control, p less than .01), which is comparable to published data for their male counterparts. Hypertriglyceridemia, not hypercholesterolemia, was found in this female population, but was not significantly correlated with any specific ABO blood group. Rhesus factor was not significantly different from the control population. There was a trend toward occlusive, rather than stenotic, atherosclerosis among women with blood group A. Statistical analysis revealed that blood group A was not just a marker for other standard cardiovascular risk factors, but rather represented an independent risk for peripheral occlusive disease.