After a 4-week wash-out period, picotamide was administered to 25 patients affected by chronic arteriopathy of the lower limbs (scale 2 according to Fontaine) at a dose of 900 mg/die for 90 days, and then at a dose of 600 mg/die for a further 90 days, in order to assess its efficacy according to the following parameters: duration of gait, residual pressure index (RPI) resting the ankles, hematochemicals, electrocardiogram. At the end of the study a statistically significant increase was observed in the duration of gait and RPI at the ankles and, of the hematochemical parameters, in an increase in fibrogenic degradation products. Adverse reactions were only observed in 3 patients and regressed spontaneously. In conclusion, picotamide was found to be efficacious in patients affected by chronic obliterating arteriopathy of the lower limbs with the possibility of reducing the dose after 3 months of therapy.