Summary:We describe the results obtained with the use of laser thermal balloon angioplasty (LTBA) in the treatment of atherosclerosis obliterans of the lower limbs in 37 patients (34 males, 3 females, mean age 58 f 9 years) with occlusive arterial disease (Fontaine stages 11-IV) presenting 39 significant lesions. Immediate results and two years of clinical follow-up are analyzed. Initial anklehrachial Doppler index was 0.5 1 If: 0.17. Eighteen lesions were located in the iliac area (13 stenoses 2.3 * 1 cm and 5 occlusions 4.2 f 3 cm) and 2 1 lesions in the femoropopliteal area (5 stenoses 2.6+2 cm and 16 occlusions 5.7f3 cm). A percutaneous procedure was used in 38 cases. In only one case was femoral dissection needed. The laser source was argon in 26 cases and Nd-YAG in 13. Initial success was 85% (89% in iliac lesions and 81% in femoropopliteal lesions; 100% in stenoses and 70% in occlusions). The presence of occlusion (p <0.01) andor calcium (p <0.05) negatively influenced the immediate results. No major complications were observed; seven (17%) minor complications occurred. Anklehrachial Doppler index after treatment was 0.82k0.21. Cumulative clinical patency for successfully treated patients after two-year follow-up was 91%. LTBA thus represents an effective and less aggressive way of treating peripheral atherosclerosis obliterans. In spite of some limitations, it is useful in selected patients. The results of this study are very much like those in the literature for similar series and early experience.