Clinicians have become interested in hemorrheologically oriented treatment of limb ischemia because of the increasing evidence that (a) hemorrheological abnormalities play an important role in the pathophysiology of circulatory diseases, and (b) such treatment may also be useful in the management of ischemia due to other causes. Possible hemorrheological approaches to management of limb ischemia can be classified according to the primary hemorrheological determinant being treated: the red cell concentration, plasma proteins, or the flow properties of individual red cells. Hemodilution, difibrinogenation with an oral agent, and the use of drugs to improve red cell deformability represent possible therapeutic approaches. The feasibility, advantages, and shortcomings of each of these treatment modalities are explored.