Screening for peripheral lower limb arterial occlusive disease (PAOD) is a major challenge for the prevention, management and treatment of patients with arteriosclerosis. The Ankle Brachial Index (ABI) is the reference method, it requires expertise and time which are limiting factors for systematic screening. The analysis of a photoplethysmographic (PPG) wave form in the lower limb can be an interesting alternative. In a retrospective pilot study we analyzed the possibility of detecting PAOD by measuring the up-stroke time wave form (UTP) at the toe by PPG method. The ABI (minimum of 2 leg arteries) and the UTP (pOpmeter® - Axelife - France) were collected in 54 patients during a vascular assessment and presenting different stages of PAOD. Of the 108 lower limbs registered, 25 were excluded for technical difficulties (very severe PAOD, mediacalcosis, toe amputation). 83 lower limbs were analyzed. Mean age was 69 ± 12; 75% men, 28% diabetics, 47% hypertensive. 17% without PAOD (stage 0); 44% stage 1; 23% stage 2; and 2% Stage 3. The 200 milliseconds UTP threshold identifies PAOD from stage 1 with: sensitivity 77%, specificity 94%, a positive predictive value 96% and negative predictive value 68% (Yule Q = 0.96). UTP makes it possible to identify an PAOD in 100% of patients with mediacalcosis (ABPI > 1.4, n = 3, diabetic = 2). The UTP measured by PPG at the toe is a simple and rapid method (< 2 min) detects the PAOD stages 1 to 3 with 94% specificity, 77% sensitivity that must be improved by using other thresholds to optimize the test. These results have to be confirmed with a prospective study.