Arteries of 98 legs amputated for diabetic and arteriosclerotic gangrene were studied, as well as arteries of diabetic patients whose death was not associated with the lower limb pathology; 10 legs of subjects killed in an accident were examined for control. The authors applied histological, histochemical, angiographical, and morphometrical methods in line with multifactorial statistical analysis of the revealed changes. Morphological manifestations of the arterial changes found in the lower limbs of patients with diabetic and arteriosclerotic gangrene appeared to vary significantly in frequency and predominant localization of lipid/fibrous plaques and organized thrombi causing the occlusion of major arteries, in the patterns of plaque and muscular layer calcinosis, as well as in the features of the development of collateral circulation. Therefore, the authors consider diabetic macroangiopathy not as early acute arteriosclerosis, but as a separate pathologic entity.