Applications of laser energy for treatment of vascular disease have recently received much attention; metal-tipped laser probes are being investigated as a device for recanalization of occluded arteries, especially as an adjunct to balloon dilatation. Developments in instrumentation and techniques have reduced the incidence of complications, notably perforation, to an acceptable level. Initial data show that recanalization of iliac, femoral, and popliteal lesions can be accomplished in a majority of cases, with the chance of success being inversely proportional to the length of occlusion. Results in the tibial vessels are disappointing. Patency of the treated vessels at 12 months appears to be superior to that of percutaneous transluminal angioplasty for similar lesions but inferior to that of surgical bypass for all occlusions greater than 3 cm in length.