Abstract: Objective: To investigate the application value of 3D CE-MRA in diagnosis of atherosclerosis occlusive disease of lower extremity. Methods: 64 patients which were diagnosed as LEASD by clinic underwent both 3D CE-MRA and DSA examination of bilateral arteries of lower extremity, and were analyzed if there were any difference between the results. Results: Taken DSA as the golden standard, the detection rate and grade of 3D CE-MRA in lower extremity artery stenosis and occlusion was compared with DSA. The value of Kappa 0.84 ≥ 0.75 and showed a good consistency with no statistical significance(<i<P</i<<0.05). However, diagnosis of 3D CE-MRA in lower extremity artery stenosis and occlusion had over-estimation and under-estimation to some extent. The rate of over-estimation for slight stenosis, moderate stenosis, sever stenosis were respectively 3.3%(11/332), 4.0%(5/125), 4.5%(5/112). The rate of under-estimation for moderate stenosis, sever stenosis, occlusion were respectively 9.6%(12/125), 4.0%(5/112), 15%(20/132). Taken DSA as the standard, the sensitivity, specificity and positive predictive value and negative predictive value of 3D CE-MRA in lower extremity artery stenosis and occlusion were 93.7%(701/753), 93.1%(563/605), 95.1%(701/737), 94.9%(563/599). Conclusion: 3D CE-MRA of lower extremity artery is a nontraumatic, nonradioactive and effective vascular examination. It could be the optimizing examination for LEASD.