Thromboangiitis obliterans (TAO) or Buerger’s disease is a segmental inflammatory, thrombotic occlusive peripheral vascular disease with unknown aetiology which usually involves the medium- and small-sized neurovascular bundle of young male smokers. TAO appears to be rare in Northen America and Western-Europe, uncommon in the Middle-East and Far-East and common in South-East Asia. Unfortunately, even today the disease features of TAO that remain misunderstood or underappreciated. The aetiology and pathophysiology of the disease are still unclear. Although most TAO patients develop the disease after a period of considerable mental stress, the psychological components of TAO are largely unexplored. Also, the diagnosis and treatment of TAO are still challenging. In spite of an increase in the number of studies that have attempted to unravel the causes and potential treatments of TAO, we have not seen a great improvement in the treatment and outcome of TAO patients. We simply know that TAO patients should quit smoking completely in addition to undergoing treatment to reach the optimum benefit of any treatment. Unless we carry out large-scale epidemiological research and well-designed treatment studies, we will not be able to fully understand the mechanisms and pathogenesis of the disease, or to elucidate how it can best be prevented or treated.