The National Cholesterol Education Program (NCEP) has included peripheral vascular disease (PVD) in its guidelines as a risk factor in the Classification and Decision for Treatment Algorithm. This means that patients who have PVD and elevated LDL-C and one other risk factor such as male gender, family history, cigarette smoking, or hypertension, should have appropriate dietary intervention followed by drug therapy as needed. Even with the guidelines in place since the end of 1987, a survey of PVD patients referred to a major medical center clinic found that very few patients were on lipid lowering therapy, either diet or drug. The reason for the primary care community not modifying lipids in these high risk patients may be related to lack of studies demonstrating benefit of lipid modification in those who have PVD. It is anticipated that many patients with PAD will require treatment for elevated LDL-C. It is not as clear whether interventions aimed at raising HDL-C will result in a slowing of progression of atherosclerosis in this population.