Bilateral lower limb angiography was performed on 58 patients with leprosy and compared with bilateral lower limb angiography performed on 63 non-leprosy patients. The vessels in leprosy were narrow and constricted. Decreased blood flow through arteries in the distal third of the lower limb was present. Abnormal AV fistula formation in the thigh and calf muscles and in trophic ulcers of the feet was also seen. Deep inflammatory granulomatous reaction surrounding the arteries as a result of leprosy is a possible explanation for these angiographic findings and is felt to be related to trophic ulceration. These findings were specific for leprosy, precede clinical manifestations, and are helpful in management.