There is limited evidence that certain heritable thrombophilias may be associated with an increased risk of peripheral vascular disease. In particular, increased activated protein C resistance and FV Leiden have been described as being more prevalent in patients with peripheral arterial disease. There is no clear evidence at present, however, that other heritable thrombophilias are associated with an increased risk of arterial occlusive disease. Heritable thrombophilia, in particular FV Leiden, may be associated with an increased risk of vascular reconstruction failure but there is a lack of evidence to show that intervention with anticoagulants influences the outcome of graft surgery in these patients.