The high incidence of medial calcification in the distal arteries of lower extremities in diabetic patients is responsible for most of the errors made in measuring ankle-pressure index. Because digital arteries are rarely calcified, digital pulse volume recording has been proposed as a specific and complementary test. Between March 1993 and March 1996, this test was performed in addition to ankle-pressure index in 66 diabetic patients. The ankle-arm index was overestimated and erroneous in 89.4% of cases. Digital arteries were calcified in 74% of cases and diabetic neuropathy present in 53% of cases. Assessment of the severity of arteritis by digital pulse volume recording (category 1 to 5) has led to better prevention and treatment. It is an essential test for the assessment of arteritis in diabetics, but also for the prediction of success of a surgical procedure: distal amputation, lumbar sympathectomy and arterial reconstruction.