The article tells about the causes and mechanisms of chronic obliterating diseases of lower limb arteries (CODLLA), diagnosis and current views on the treatment of the disease. CODLLA account for up to 20% of all cardiovascular pathologies, while the risk of the disease increases with age. Atherosclerosis is considered to be the main cause of CODLLA: obliterating atherosclerosis of arteries accounts for up to 90% of all cases of CODLLA. The early stages of this disease are asymptomatic; the unattended disease results in complaints of leg pain at rest or during exercise (intermittent claudication), convulsions and in severe cases - trophic ulcers. The basic principle of CODLLA therapy is continuity and use of all available pharmacological and non-pharmacological treatments. Alprostadil (Vazaprostan) is commonly used in the treatment of CODLLA. It is a synthetic prostaglandin Е1which dilates the arterioles and precapillary sphincters increasing tissue blood flow, with an anti-inflammatory and cytoprotective action.