Objective: Both hypertension and diabetes lead to accelerate atherosclerosis. Moreover, most of the peripheral arterial atherosclerosis of the lower extremities are without any symptoms for a long period. There is a need for screening examinations because otherwise it would be recognized only several years later. Screening of peripheral atherosclerosis of lower extremities at high cardiovascular risk patients and determining the prevalence of the silent peripheral atherosclerotic disease. Design and method: 430 consecutive out-patients were involved in this study suffering from both hypertension and type 2 diabetes. With the help of a validated BOSO ABI-100 we measured ankle-brachial index (ABI). Based on recent guidelines we considered abnormal if ABI < 0.9. Results: The mean age was 68.6 ± 8.1 years, 202 males and 228 females were involved. 80.9% of the patients were on pharmacological treatment of hypertension. Diabetes was treated only with lifestyle-therapy in 5.1%, while 62.6% were exclusively on oral antidiabetics and 23.7% on insulin therapy. 8.6% of the patients were administrated with both oral and insulin therapies. Less than half of the patients were on statins (48.4%). The antihypertensive therapy was more frequent among females, while statins among males (77.2% vs. 84.2%; p < 0.01 and 50.5% vs. 46.5%; p < 0.05). 17.8% of the patients had previously acute coronary syndrome, whereas 5.3% had stroke. Among the 202 male patients we observed ABI < 0.9 at least on one side in 60 cases (29.7%) while in 35 patients (17.3%) ABI was less than 0.9 on both sides. 39 females (17.1%) had ABI < 0.9 and in 18 cases (7.9%) this result was found in both sides. The ABI < 0.9 was slightly more frequent on the right side (males: 50 vs. 45 cases, females: 30 vs. 27 cases). Conclusions: This painless and easy-to-do screening examination is a useful tool especially at high cardiovascular risk (eg. hypertensive diabetic patients) because in 23% of all cases we observed abnormal data, suggesting the presence of the peripheral atherosclerosis. Early diagnosis, conscious lifestyle and aggressive pharmacological therapy can improve the prognosis and decrease the progression of the atherosclerosis.