Primary care physicians have an important role in identification and referral of patients with signs and symptoms of peripheral vascular disease. Advances in technology have increased the effectiveness of percutaneous catheter-based techniques used to treat stenosis or occlusion in various anatomic sites. However, early evaluation remains an important factor in the success of treatment. In this symposium article, Drs Lips and Vacek review the current catheter-based techniques for managing various types of occlusive disease and include numerous angiographic illustrations from their case files. They also examine the factors affecting choice of treatment approach and briefly discuss the role of thrombolytic therapy.