Arteriography is the imaging modality of choice before lower limb revascularization, because it allows pinpointing of the diseased arteries and planning of the treatment strategy, be it PTA or bypass grafting. However, a 2-3% risk of complications, makes assessment of non-invasive alternatives mandatory. Insufficient contrast filling of infrapopliteal arteries distal to severe lesions have also challenged the status of arteriography as the gold standard before revascularisation. The use of duplex arterial mapping is a promising alternative, as it has the highest agreement in the femoral segment and the lowest in the infra-popliteal segment. Duplex arterial mapping is a reliable means of predicting whether patients will require a bypass graft or an endovascular procedure, and, if surgery is required, in predicting the actual location of both anastomoses.