The diagnosis and treatment of lower extremity ischemia rely on precise imaging assessment, which was conventionally performed mainly by biphasic ultrasound, intra-arterial digital subtraction angiography (DSA), computed tomography angiography (CTA), and magnetic resonance angiography (MRA). These modalities are all intended to assess the vascular anatomical structure in limb ischemic changes. In recent years, imaging technologies for assessment of blood perfusion imaging in the ischemic area have been used for diagnosis and treatment in peripheral arterial disease, which include laser Doppler flowmetry, hyperspectral imaging, indocyanine green angiography, and so on. The improved conventional imaging techniques and the emerging perfusion imaging modalities provide vital information for the diagnosis and treatment of lower extremity ischemia, and their combination has been found of great clinical significance.