Data suggest that ischemic renal disease secondary to atherosclerotic renal artery stenosis is a prevalent health problem. Atherosclerotic renal artery stenosis is a rapidly progressive process that can result in end-stage renal disease. Renal arteriography is the current diagnostic method of choice for the demonstration of renal artery stenosis. Captopril renography, nuclear magnetic resonance angiography, and duplex scanning are promising screening tests for this disorder. Therapeutic options include medical management, percutaneous angioplasty, and surgical revascularization.