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Introduction: The prevalence of diabetes mellitus (DM) is increasing worldwide and is a major risk factor for peripheral arterial disease (PAD). Patients with DM have a predisposition toward a higher burden of atherosclerotic disease below the knee compared to non DM. Doppler ultrasonography is a noninvasive investigation in the evaluation of lower-extremity arterial disease. Another commonly utilized imaging modality is multidetector computed tomography angiography (MDCT). It is an attractive option, it is minimally invasive, there are shorter acquisition times, that enable scanning of the whole vascular tree in a limited period with a smaller amount of contrast medium. Aim The aim was to evaluate a better less invasive assessment of lower limb arterial insufficiency in patients with diabetes. Materials and methods: MDCT and Doppler's examinations were performed on 24 diabetic patients presented with signs and symptoms of lower limb ischemia; Doppler examinations were performed with (GE Logiq P7 Ultrasound Machine), which can combine a real time B-mode imaging system with pulsed and continuous wave Doppler facilities together with the availability of color coding of signals. MDCT will be performed with a PHILIPS ingenuity 128 slice CT scanner. The images were analyzed based on transverse images, maximum intensity projection, multiplanar reformats, and volume-rendering images for stenosis, occlusion, calcification, plaque morphology, and collaterals. Results: In all, there were 24 patients; there was no major difference between the results of Doppler ultrasound and CT angiography. The Doppler examination results had some trend of stenosis overestimation but it was unlikely to miss significant stenosis in different segments. Conclusion: Both MDCT angiography and Doppler US have a good predictive value of chronic lower limb ischemia in diabetic patients, but the combination of them has better diagnostic accuracy. [ABSTRACT FROM AUTHOR]