Numerous reports document the role of vascular adhesion molecules in thedevelopment and progression of atherosclerosis. E-selectin plays a role in the early stagesof vascular disease by facilitating the attachment of leukocytes to the endothelium.Polymorphism in the E-selectin gene leading to a replacement of serine by arginine atposition 128 has been associated with premature coronary artery disease. Intercellularadhesion molecule-1 (ICAM-1) plays a crucial role in lymphocyte migration andactivation, and is considered important in the pathogenesis of atherosclerosis. The aim ofthe present study was to evaluate the association between gene polymorphism of Eselectinand ICAM-1 and peripheral arterial occlusive disease (PAOD) in Egyptian. Weinvestigated 2 mutations, namely S128R in E-selectin and K469E in ICAM-1 in 52patients with PAOD and 30 control subjects using polymerase chain reaction–restrictionfragment length polymorphism (PCR-RFLP) analysis in an Egyptian population. Patientswere classified into 31 diabetic and 21 non diabetic subjects. The distribution of E-selectin genotypes in patients affected by PAOD was 84.6% AA genotype and 15.4% AC genotype. The distribution of E-selectin genotypes incontrol subjects was 96.7% AA and 3.3% AC. The AC genotype was significantly morecommon in patients than controls. Additionally, the distribution of ICAM-1 genotypes inpatients affected by PAOD was 30.8% EE, 48% EK, and 21.2% KK. The distribution ofICAM-1 genotypes in control subjects was 13.3% EE, 33.4% EK and 53.3% KK. The EEgenotype was significantly more common in patients than controls. It is interesting in thisstudy those patients having AC genotype, also having EE genotype.Conclusions- Our data support the hypothesis that inflammatory mechanisms areimportant in the pathophysiology of vascular diseases with an atherosclerotic basis. Eselectingene S128R polymorphism and ICAM1 gene K469E polymorphism wereassociated with increased risk in PAOD. The E allele may serve as a genetic risk factorfor PAOD.Early detection of these gene polymorphism helps in early prophylaxes against PAOD.