Background: The risk of peripheral arterial disease is significantly increased among diabetic individuals, as presented through multidetector computed tomography angiography (MDCT). There are numerous benefits to choosing this path. Objective: To evaluate the lower limb arteries by multidetector computed tomography angiography. Patients and methods: MDCT examinations were performed on 24 diabetic patients who presented with signs and symptoms of lower limb ischemia; MDCT will be performed with PHILIPS ingenuity 128 slice CT scanner. For stenosis, occlusion, calcification, plaque structure, collaterals, transverse, maximum intensity projection, multi-planar, and volume-rendering images were used. Results: At least 22 segments had severe stenosis, defined as luminal narrowing of more than 50% and PSV ratio of more than 2, Fifty segments were occluded, eight had no distal collateral refilling, and five had nonsignificant stenosis (luminal constriction lower than 50% of arterial diameter and PSV lower than ratio 2). Conclusion: MDCT for evaluation of lower limb ischemia should be considered as the investigation of choice for pre-operative assessment and follow-up; being less invasive and provides angiography-like high-resolution images which are familiar to vascular surgeons.