Abstract To evaluate the results of percutaneous transluminal angioplasty (PTA) of the tibial vessels, results of 50 procedures performed in 38 patients since 1988 were analysed retrospectively. A total of 73 tibial vessels were treated: 32 anterior tibial arteries, 16 posterior tibial arteries, four peroneal arteries, 12 tibioperoneal trunks and nine trifurcation lesions. Forty-four of 50 PTA procedures were performed in conjunction with interventions in the femoropopliteal arteries and six as isolated procedures. One patient required a femorodistal graft following perforation of the popliteal artery during atherectomy. Distal emboli occurred in two patients and acute thrombosis of both the angioplastied tibial vessels occurred in a third. The technical success rate was 96 per cent. Patients were followed for a mean(s.d.) of 21(13) months. At the latest follow-up, 58 per cent had improved clinically. There were significant improvements in 43 per cent of limb isotope blood flow studies and 52 per cent of ankle : brachial Doppler pressure indices in treated limbs at this time. PTA should be the first treatment option in patients with infrapopliteal arterial disease needing intervention, whenever it is technically feasible.