A 59-year-old male with short distance exercise-induced left leg pain. The pain was severe and was interfering with the patients actively living. He was seen and treated for neurogenic claudication for several months without any improvement. The patient had palpable pulses in the left foot, which was mistaken as indicating he had good blood flow to the leg. There is a common misconception that pulses in the foot mean that there is no significant peripheral arterial disease. All patients with exertional leg pain (pain when walking) need to be evaluated with an exercise ankle-brachial index study (ABI). In 1 hour, the patient was treated and resumed refereeing soccer games 48 hours later.