Expertise in caring for patients with vascular disease requires a comprehensive and sophisticated knowledge base of vascular diseases, skills in patient evaluation, and a thorough understanding of the therapeutic options available to treat these patients. Physicians with expertise in vascular medicine would be expected to diagnose and coordinate treatment of all vascular disorders, including aortic diseases, peripheral arterial disease, cerebrovascular disease, renal artery stenosis, vasculitis, atherothrombotic embolism, vasospastic disease, autonomic dysfunction, venous thromboembolic disease, chronic venous disorders, lymphatic disease, as well as other less common vascular diseases. They should also be able to identify and treat disorders that contribute to vascular disease, such as dyslipidemia, hypertension, diabetes, and hypercoagulable states. These physicians should understand the epidemiology, pathology, pathophysiology, clinical presentation, natural history, and therapeutic options relevant to each vascular disease. Expertise in the noninvasive vascular laboratory, including the ability to perform and interpret duplex ultrasound examinations of the veins and arteries of the limbs, the aorta and its branches, carotid arteries, and vascular bypass grafts, and also physiologic tests of peripheral arteries and veins, is desirable. In addition, specialists in vascular medicine should be skilled in the interpretation of other imaging modalities, including magnetic resonance and contrast angiography. Physicians who specialize in vascular medicine also should have a thorough understanding of the indications for, and potential outcomes of, invasive diagnostic procedures, catheter-based treatments, and vascular surgery.