The diagnosis of intermittent claudication due to peripheral artery disease is often clearly suggested by a thorough history and physical examination. Symptoms arise in a lower extremity muscle group with a predictable amount of exercise; they abate with rest. The medical history will identify vascular risk factors, most commonly, a history of tobacco exposure. Physical exam focuses on a peripheral pulse exam. Diagnostic testing begins with noninvasive studies of perfusion, such as an ankle-brachial index. Additional diagnostic imaging may be warranted in some cases, to delineate specific anatomic characteristics of the atherosclerotic disease.