Two low-osmolality contrast agents, ioxaglate meglumine/ sodium and iohexol were compared with diatrizoate meglumine/sodium in a controlled double blind study of 126 patients undergoing arteriography for peripheral vascular disease to determine which caused the least pain. Discomfort was assessed by means of a visual analog scale rating pain from 0 to 100. Average values for pain were 39 ± 27 for diatrizoate, 14 ± 15 for ioxaglate and 21 ± 22 for iohexol. We found that both low-osmolality agents caused significantly less pain in peripheral arteriography than the traditional agent. The p values were p < 0.0005 for ioxaglate and p < 0.005 for iohexol versus diatrizoate. In addition, ioxaglate was found to cause significantly less pain than iohexol (p < 0.05) in this patient group.