Peripheral vascular disease is a common cause of morbidity all around the world. Epidemiological studies indicate that up to 5% of men and 2.5% of women 60 years of age or older have symptoms of intermittent claudication. Until as recently as ten years ago, catheter-directed conventional angiography and digital subtraction angiography were the only angiographic techniques that provided sufficient anatomical details to allow surgical planning for patients with peripheral vascular disease. However the complications and patient discomfort associated with these techniques have prompted the need of less invasive means of assessing the lower extremity arterial system. CT angiography has been shown to be accurate in the investigation of a number of diseases, but long gantry rotation periods and slow table speed limited the performance of CT angiography with single-detector scanners to relatively small anatomical areas. Multi-detector row CT scanners (MDCT) allow imaging over cranio-caudal lengths exceeding 1.5 meter. Imaging of the entire arterial supply of the lower extremities in a single helical acquisition is possible by MDCT. The aim of this study is to evaluate the MDCT angiography as a recent non invasive technique for investigating peripheral arterial disease as compared to CCD and DSA. This study included 22 patients (19 males & 3 females) with an age range of 31 – 71 years. All of these patients underwent MDCT angiography and CCD. Only 16 patients underwent DSA. The arterial tree of the lower limbs was divided into 31 arterial segments. Each segment was evaluated and given a grade from 0 to 4 according to its appearance in the three modalities. There was a 96.7% agreement between the findings of DSA and MDCT angiography. While agreement between DSA and CCD was 97.3%. The sensitivity of MDCT angiography in this study was 88.9% when considering the conventional angiography as the gold standard, while the sensitivity of the color coded Doppler was 90.2%. MDCT angiography was able to detect 13 infra-popliteal arterial segments distal to an obstruction that were not seen in DSA. MDCT angiography has proved to be a less invasive and a reliable method of investigating the lower limb arterial disease with results comparable to DSA. MDCT angiography as a less invasive imaging modality may be used for preoperative assessment of lower limb arterial disease. Conventional angiography may be spared for patients who are candidate for interventional procedures (e.g. angioplasty or stent application). Color coded Doppler is also a reliable non-invasive method of investigating the lower limb arterial system. It has an advantage over conventional angiography and MDCT angiography that it provides us with data about the velocity of blood distal to the obstruction and shape of the waveform that adds more to determining the hemodynamic significance of this lesion.