Good blood supply is a primary determinant for the healing of acute and chronic wounds alike. Chronic wounds commonly occur in the lower extremity in man. Scientists are forever looking for objective techniques with which tissue perfusion may be measured with accuracy. Laser Doppler imaging is a very useful technique for measuring microvascular perfusion in wounds because it involves no contact and produces a color image representing flow distribution over an area of tissue. In this article, the authors discuss its application to the assessment of lower limb wounds, and they review published studies in which it has been used to investigate a range of wound types. This review examines the study of healing mechanisms, treatment effects, risk prediction, healing potential, and underlying pathology. It also considers areas in which laser Doppler imaging is still to be exploited fully.