Evaluate whether common femoral artery (CFA) Doppler waveform assessment predicted the presence of significant iliac artery stenosis as visualised on magnetic resonance angiography (MRA). Three-year retrospective study of patients investigated using CFA Doppler waveforms and MRA. The patients were identified from vascular/radiology databases. Waveforms were reported real time as monophasic, biphasic or triphasic. Results were compared with MRA findings. In 76 patients, 119 waveforms were assessed. MRA demonstrated 37 iliac vessels with significant stenosis. 32 (86%) had abnormal waveforms (monophasic/biphasic), 5 were triphasic. In 82 cases where MRA showed no significant stenosis, waveforms were abnormal in 35 (43%). Abnormal CFA waveforms have sensitivity of 86% and specificity of 57%. Monophasic waveforms alone were more specific (88%) but less sensitive (57%) for predicting iliac lesions. Whilst CFA waveform morphology is a useful adjunct in detection of iliac disease, normal triphasic waveforms do not exclude iliac stenosis.