The treatment of arterial and venous cutaneous ulcers in vasculopathic patients is a difficult task, since it requires the prolonged administration of drugs which are often unable to correct the various pathogenetic factors, including rheological disorders, responsible for the lesions. The authors, basing themselves upon recent studies demonstrating the rheological and vasoactive as well as metabolic activities of propionyl l-carnitine, have decided to examine this substance for the treatment of arterial and venous cutaneous ulcers of the lower extremities. Propionyl l-carnitine administered orally or intravenously to eighteen vasculopathics with cutaneous ulcers was responsible for the complete or nearly complete regression of trophic lesions in 78.9% of the patients. Therapeutic failure or only modest results were observed in four patients. In addition a highly significant increase in flow velocity was observed in arteriopathic patients. It is particularly important to note that these clinical results were obtained in patients refractory to all other forms of therapy.