The protean clinical manifestations of atheroembolic disease (AED) mimic systemic disorders with kidney involvement. Acute or chronic renal failure develops spontaneously or more frequently after an inciting event in patients with AED. Significant proteinuria and nephrotic syndrome, however, constitute uncommon findings. We present four patients with AED documented histopathologically who developed nephrotic-range proteinuria. The mechanisms of proteinuria are discussed, and it is suggested that AED be considered in the differential diagnosis of nephrotic syndrome in elderly patients with serious vascular disease.