Acute occlusion of the aortic bifurcation or distal branches can cause sudden onset of pain at rest, pallor, paralysis, absence of peripheral pulses, and coldness in the legs (see Acute Peripheral Arterial Occlusion).

Chronic occlusion can cause intermittent claudication in the legs and buttocks and erectile dysfunction (Leriche syndrome). Femoral pulse are absent, and ankle-brachial index is abnormal. A limb may be jeopardized.