Buerger's disease also called thromboangiitis obliterans (TAO) is widely recognized as a specific disease characterized by onset of distal extremity ischemic symptoms at early age in absence of an underlying proximal embolic source trauma autoimmune disease diabetes or hyperlipidemia.1The disease is far more prevalent in the middle near and far east regions than in North America.2 It occurs predominantly in men but recent evidence indicates that the incidence rate in women is increasing.3Treatment of Buerger's disease is primarily medical.Surgical treatment in non responders to medical management including lumbar sympathectomy has been tried without promising result. Various orthopaedic procedures have been tested in various studies for the treatment of peripheral vascular diseases with variable successes.We have used Ilizarov surgery to distract and then compress to produce stimulus for angiogenesis.Vascular Endothelial Factor (VEGF) is an angiogenic factor which stimulates endothelial cell growth angiogenesis and capillary permeability.4 In this study we have measured the clinical improvement parameters and VEGF level after ilizarov procedure in peripheral arterial vascular disease.