We studied the preliminary results of atherectomy of atherosclerotic lesions involving the lower extremities in 10 patients. Fifteen arterial stenotic lesions, five iliac, eight superficial femoral, one popliteal, and one anterior tibial, were treated. Five lesions were re-stenoses after balloon angioplasty, while the remaining lesions were previously untreated primary stenoses. For atherectomy, over-the-wire atherectomy catheters ranging in size from 7 to 10-F were used. Balloon angioplasty was also performed in cases 3, 6 and 9. Atherectomy was considered a success in all patients based on angiographic and clinical criteria. Complications occurred in three patients: intimal dissection, distal embolism and arterial spasm. In the patients with distal embolism, a surgical approach was required to remove the embolus. The internal elastic lamina or media was resected in 10 lesions on the histopathologic specimens. Although further assessment of complications and long-term results is required, these results suggest that atherectomy is useful for treating occlusive peripheral vascular disease.