Peripheral nerve conduction studies were performed on 32 limbs in 25 patients to determine the incidence of peripheral nerve conduction defects and prospectively evaluate the influence of revascularization in patients with lower extremity ischemia. Ankle pressure indices improved from a mean preoperative value of 0.43 +/- 0.12 to 0.81 +/- 0.26 in patients with aortoiliac disease and 0.40 +/- 0.13 +/- 0.84 +/- 0.19 in the limbs of patients with femoropopliteal disease, P less than 0.001. When compared to controls, there were significant nerve conduction abnormalities detected in the common peroneal and posterior tibial nerves of patients with aortoiliac and femoropopliteal disease preoperatively, P less than 0.02. Postoperatively, there was no improvement in nerve conduction, amplitudes, or velocities in the common peroneal or posterior tibial nerves when compared to preoperative values. However, distal latency in the sural nerve in patients with aortoiliac disease was prolonged indicating deterioration in function. Nerve conduction abnormalities in patients with aortoiliac and femoropopliteal occlusive diseases are often present in patients with lower extremity ischemia and are not significantly improved by revascularization. These observations may indicate nonreversible changes as a result of chronic ischemia.