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A rare case of bilateral popliteal artery entrapment syndrome is reported. Pathological changes of the occluded lesion in this anomaly were investigated in 8 other cases. Abnormal longitudinal muscle in the media was noted in all. Development of these muscle bundles was considered to be due to chronic trauma inflicted by pressure on the arterial wall. Its significance is emphasized to assist in differentiation from other chronic arterial occlusive disease.
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