<p>The major vessels of the left lower limb were examined using high resolution transducer on gray scale and Doppler protocols. The exam was done from the groin to the dorsum of the foot.</p><p>The outlined common femoral, distal popliteal, peroneal and both tibial arteries showed variable thickening of the intimal media and absence of colur flow. The lumen of the common femoral artery is filled with mixed echogenic material. However, trickles of flow was noticed in the popliteal artery with power Doppler protocols, associated with parvus tardus pattern on spectral Doppler analysis.</p><p>The corresponding veins as well as the superficial veins showed normal caliber, compressibility and colour flow. The wave form of these veins were characterized by usual respiratory phasicity and positive augmentation responses. There is no evidence of intra luminal filling defect to suggest a thrombus.</p><p>Conclusion: Findings suggest severe left femoro-popliteal arterial stenosis with poor distal run-off.</p><p>CT-angiography of the abdominal aorta and both lower limb is recommended for detailed evaluation.</p>