Objective:To investigate the application value of superb microvascular imagingin monitoring angiogenesis in the treatment of chronic ischemic diseases of lower limbs by tibial transverse transport.Methods:From May 2019 to December 2020, 12 patients with ischemic diseases of lower limbs who received tibial transverse transport therapy were retrospectively analyzed, including 7 male patients and 5 female patients, aged 30-86 years, with an average age of 64.0±16.6 years. Among them, there were 10 patients with diabetic foot, with a disease course of 5-30 years (mean 14.4±8.3 years), and 2 patients with arteriosclerosis obliterans. The results of lower extremity superb microvascular imaging before and after treatment were recorded and compared.Results:After treatment, 12 patients were found to have obvious new vessels around the artery of lower extremity, the number of vessels 1-8, the average number of 3.25±2.73. We found that a total of 12 patients 20 inherent lower limb artery collateral established, collateral circulation was found around 12 dorsal metatarsal artery (DMA) in 11 patients, around 3 dorsal pedis artery (DPA) in 2 patients, around 3 anterior tibial artery (ATA) in 2 patients, and around 1 posterior tibial artery (PTA) in 2 patients. The lateral branches were established in ipsilateral lower limbs in 6 patients, contralateral lower limbs in 2 patients, and bilateral lower limbs in 4 patients.Conclusion:The phenomenon of angiogenesis is obvious in the clinical application of tibial transverse transport. Superb microvascular imaging can effectively reflect the degree of promoting the establishment of collateral circulation by tibial transverse transport.