Intermittent claudication is a common complaint among the elderly. It is mostly caused by atherosclerosis but also by stenosis of lower limb arteries resulting from giant cell arteritis. Distinct characteristics can be observed of giant cell arteritis and atherosclerosis on such imaging modalities as sonography, computed tomography angiography and magnetic resonance angiography. The two conditions can be effectively distinguished by imaging findings and clinical features, providing guide for patient′s management. In this article, we reported the progress in the diagnosis and treatment of intermittent claudication of lower extremities by reviewing recent studies on the condition caused by large-vessel giant cell arteritis.