Thirty-six patients with a median age of sixty-seven years and a median duration of intermittent claudication of five years were randomized to either active treatment with Padma 28 or placebo. The effect of treatment was quanti fied by measurements of systemic and peripheral systolic blood pressures and by measurements of the pain-free and the maximal walking distance on a tread mill. The ankle pressure index (ankle systolic pressure/arm systolic pressure) was calculated.The group randomized to active treatment received two tablets bid contain ing 340 mg of a dried herbal mixture composed according to an ancient lamais tic preparation (Padma 28). After active treatments, administered over a period of four months in a double-blinded, randomized design, the patients allocated to this group attained a significant increase in the pain-free walking distance from 52 m (20-106) to 86 m (24-164; P < 0.05) and in the maximal walking distance from 115 m (72-218) to 227 m (73- > 1,000; P < 0.05). The patient-group receiv ing placebo treatments did not show any significant changes in either the pain- free or the maximal walking distance. The authors could not demonstrate any significant changes in the ankle pressure index either during active or during placebo treatment.In conclusion, this study has shown that treatment with Padma 28 over a period of four months significantly increased the walking distance in patients with stable, intermittent claudication of long duration.