Several medications can be used to treat patients with painful diabetic neuropathy. However, studies differ as to the efficacy of many of these agents. We hope future research will help to delineate a more exact usage of these agents in the treatment of this condition. Ischemic neuropathy as it pertains to arteriosclerosis, thromboangiitis obliterans and diabetes mellitus has been discussed in this study. The vascular anatomy of peripheral nerves has been presented. Furthermore, research has been discussed that shows diffuse ischemic results in nerve demyelination and axonal degeneration. It is hoped that this report will help to delineate the incidence and significance of ischemic neuritis in patients with peripheral vascular occlusive disease.