Patients with peripheral arterial occlusive disease (PAD) of the lower extremities have an imbalance between oxygen demand and supply to the ambulatory muscles producing pain in the calf or thigh on walking. PAD is the most common cause of severe impairment in walking ability. Claudication likewise indirectly or directly impairs the functional status of the patient by limiting social, leisure and occupational activities of these patients. Treatment of claudication if incapacitating includes revascularization. In patients with small vessel disease such as Buerger's disease treatment is primarily conservative. Exercise rehabilitation is a method that has been efficacious for treating the functional impairment associated with intermittent claudication. Exercise rehabilitation has been shown to improve pain free treadmill walking distance and absolute walking distance. We describe a young patient with Buerger's disease that underwent 12-week supervised, hospital-based exercise rehabilitation.