In briefA 46-year-old man presented with symptoms of peripheral vascular disease in 1966. In 1976 arteriography revealed 100% occlusion of both femoral arteries at midthigh and some reconstitution of flow via collaterals into the popliteal region. His cholesterol level was initially 407 mg/100 ml, and his walking tolerance was 100 yards. After a 26-day stay at the Pritikin Longevity Center, his cholesterol dropped from 230 mg/100 ml to 130 mg/100 ml, and his walking tolerance increased to 3 miles in one hour with little leg pain. He has run more than 20 road races and completed a marathon. A recent exercise Doppler exam and a second arteriogram indicated a significant increase in blood flow due to dilation of deep femoral arteries and existing collateral vessels.