Balloon angioplasty is being used with increasing frequency in the management of patients with peripheral vascular disease. Balloon angioplasty is useful alone and as an adjunct to conventional surgery. Angioplasty is relatively inexpensive, is performed under local anesthesia, and is associated with few complications. Technical success depends on the morphologic characteristics of a lesion and on the skill and experience of the operator. Long-term patency is more likely with larger vessels and short-segment stenosis. Careful selection of patients is vital and depends on cooperation between the vascular consultant and radiologist. PCTA is most often used at the extremes of clinical severity. Most complications are minor and do not require surgical treatment. The main disadvantage is the high incidence of restenosis. Angioplasty can be repeated easily, however, and its use does not preclude later surgery.