The majority of patients with intermittent claudication are treated conservatively; smoking must be stopped and exercise therapy commenced. There are various classes of drugs that are widely prescribed for the treatment of peripheral vascular disease. In this editorial the medical treatment of peripheral vascular disease is claimed to achieve at least one of three goals: (1) improvement of the functional capability; (2) inhibition of the progression of the atherosclerotic and anatomical lesions; (3) reduction of the cardiac and cerebrovascular morbidity and mortality. Guidelines are given for well controlled trials for newly developed drugs for the treatment of peripheral vascular disease in the future.