Even in the absence of symptoms, peripheral arterial disease carries with it a significant risk of morbidity and mortality; thus, screening with the use of the ankle-brachial index is important in identifying patients at risk. Endovascular therapy in the lower extremities is continually evolving for treatment of patients with claudication symptoms or limb-threatening ischemia. Alternative treatments such as cryotherapy and the use of laser-assisted angioplasty hold much promise but need further investigation. In the case of renal artery stenosis and resulting hypertension, supportive clinical evidence is limited for renal revascularization despite the rationale for reducing cardiovascular risk. The current standard of care for significant carotid artery stenosis can include carotid stenting and carotid endarterectomy, but medical therapy may have a role also.