The symptoms of Leriche syndrome include gluteal pain, muscular atrophy of both lower limbs, and loss of potency in the male, symptoms which are usually associated with localized aortoiliac occlusive disease. The specific changes in the Doppler spectrum that follow the clinical manifestations of Leriche syndrome in AIOD are seldom discussed. We report 2 cases of Leriche syndrome with total occlusion of the distal aorta that were documented by aortography via a transbrachial route. The abnormal common femoral artery (CFA) Doppler spectrum revealed before angiography was useful in localizing the vascular lesion. Monophasic waveform combined with a peak systolic velocity of <45 cm/s of the CFA Doppler spectrum helped us avoid an incorrect preoperative diagnosis and the unwarranted complications of angiography via a femoral artery approach.