Blood pressure was measured at the posterior tibial artery by Doppler ultrasonography in 440 elderly subjects (205 men and 235 women) living in a rural community of Southern Italy, together with the evaluation of traditional risk factors for cardiovascular disease. An ankle/arm systolic pressure ratio below 0.90 was considered as a definite pathological sign of peripheral arterial disease (PAD). About 10% of both men and women had a value below 0.90. Elderly subjects with PAD had higher serum triglyceride levels and a higher ratio between the cholesterol content in atherogenic (VLDL + LDL) versus non-atherogenic (HDL) lipoproteins than subjects free of PAD. The mean blood pressure was also higher in patients with PAD. The prevalence of PAD was much lower than what we have observed in institutionalized old subjects in Southern Italy.