OBJECTIVE To assess feasibility of a new technique for simultaneous measurement of digital artery and skin perfusion pressure at the same digit using the laser Doppler method and to measure the pressure gradient between the two vessel compartments in controls and patients with peripheral arterial occlusive disease. METHODS A pressure cuff wrapped around the basis of the toe and connected to a Statham transducer is covered by a special plastic capsule. A hole at the distal end of the capsule permits positioning of a laser Doppler probe at the pulp. A second laser Doppler probe is placed on the skin beneath the pressure cuff. Reappearance of pulsatile flux during cuff pressure release detected by the two laser Doppler probes indicated digital artery pressure and skin perfusion pressure on the corresponding pressure curve. Results in patients with intermittent claudication were compared to results of a group of normal controls. METHODS University Hospital, Zürich, Switzerland. METHODS Eleven healthy volunteers and 14 patients with intermittent claudication due to peripheral arterial occlusive disease were studied. METHODS Digital artery pressure (DAP), skin perfusion pressure (SPP) and pressure gradient between DAP and SPP. RESULTS Significantly lower mean DAP (95.8 +/- 23.2 mmHg vs. 49.8 +/- 20.4 mmHg; p < 0.01) and mean SPP (81.4 +/- 18.8 mmHg vs. 38.4 +/- 21.7 mmHg; p < 0.01) were observed in the patients. Mean pressure gradients and ratios between DAP and SPP did not differ significantly between the two groups. There was a linear correlation between DAP and SPP (r = 0.82, p < 0.01). CONCLUSIONS The laser Doppler method provides the possibility to measure digital artery and skin perfusion pressure simultaneously at the same digit in an easy and non-invasive way. Pressure gradients between DAP and SPP are similar in controls and patients with claudication.