Both catheter and spiral computed tomography (CT) angiography of the lower extremity vasculature were performed in six patients with clinically symptomatic peripheral vascular disease. Forty-eight arteries were studied and were independently evaluated for arterial stenoses and occlusions. Compared with catheter arteriography, CT angiography correctly depicted segmental occlusions and significant stenoses (> 50%) in 26 of 28 arteries, yielding a sensitivity of 92.9%, a specificity of 96.2%, and an overall accuracy of 95.5%.