Abstract: Objective: To study the characteristics of 64 slice spiral CT angiography (CTA) in diabetic lower extremity arterial disease (LEAD). Methods: Analyze the clinical data of 80 diabetic cases that performed 64 slice spiral CTA examination retrospectively. The arteries of lower extremity were divided into the following four segments:Iliac, femoral, popliteal and crural artery. Count on the lower extremity arterial lesions, number, feature and length (<5 cm, 5-10 cm, >10 cm), and analyze the characteristic of LEAD. Results: Of 148 diabetic lower limbs in the 80 cases, multiple segmental lesions were seen in 55(37.16%), femoral arterial lesions in 104, and crural arterial lesions in 134. Based on segmental angiographic classification, a total of 325 vascular lesions were detected, including stricture lesions (44.92%) and occlusive lesions (55.08%). Of the 134 crural lesions, 70.90% were occlusions, and most of which were longer than 10 cm and located in anterior and posterior tibial arteries, while only a few peroneal arteries were involved (P<0.05). Conclusion: The main feature of diabetic LEAD is multi-level atherosclerotic occlusion, the femoral and the crural arteries are most likely to be involved. Non-invasive MSCTA can be used for routine evaluation of LEAD.