Epidural spinal cord stimulation (ESCS) hasbeen suggested as a method to improve microcirculatoryblood flow and to reduce the amputation rate in vascularpatients. We studied the effects of ESCS onmicrocirculatory blood flow in 237 patients with nonreconstructibleperipheral arterial occlusive disease. Clinical status wasclassified as Fontaine Stage 3 (ischemic rest pain) in 169patients and as Fontaine Stage 4 (ulcers/gangrene) in 68patients. After a mean follow-up period of 31.2 months,major pain relief (>75%) was noticed in patients whoretained their limbs. Sixty-four patients underwent majoramputation despite ESCS. Clinical improvement wasconfirmed by the increase in transcutaneous oxygen(TcPo2).