Objective To evaluate the diagnostic value of 128-MDCT angiography inperipheral arterial occlusive disease. Methods Prospective for 21 patients with lower extremity artery occlusive disease (42 side body), average age (71±12.7), and obtain informed consent in Toshiba Aquilion One 128 layer spiral CT on lower limb arterial CTA (contrast agents: iodine 370 mgi palmer alcohol/mL (Iopamidol, BRACCO), bipolar, injection contrast medium dose groups by weight), the original image through VR, MIP, CPR image post-processing after reconstruction. A total of 12 patients with 12 lower limbs underwent DSA examination within 1 week after CTA examination. Two experienced radiologists were employed to analyze and evaluate the image quality and stenosis degree of each artery segment of the lower limb shown by CTA, and compared with DSA. Results 21 patients were successfully completed the double lower limb artery CTA examination, image display score was (2.86±0.351), CTA venous overlap score was (0.14±0.467)points, a total of 38 lower limb venous CTA without pollution, accounting for 90.48% (38/42). 4 lower limbs CTA of different degrees of venous enhancement, accounted for 9.53% (4/42). With DSA as the gold standard, CTA showed normal artery mild stenosis and a sensitivity of 96.30%, specificity of 98.04%, positive predictive value of 98.73%, negative predictive value of 94.33% showed obvious stenosis. Conclusion 128- MDCT can clearly show lower extremity arterial disease with important imformation for clinical diagnosis and treatment planning.