Early diagnosis and aggressive management are critical to mitigate the devastating natural history of Critical limb ischemia (CLI). Computed tomography angiography (CTA) and contrast-enhanced magnetic resonance angiography (CE-MRA) are established methods in the diagnostic workup of PAD. However, the high incidence of infrapopliteal disease in CLI and the calcified nature of these vessels in patients suffering from diabetes mellitus are problems even for the dual-energy CT. In addition, diabetic patients with CLI frequently experience several comorbidities, which can hamper administration of iodinated contrast media and lead to contrast-induced nephropathy. What’s more, the high prevalence of chronic renal impairment in diabetic patients with CLI and CE-MRA studies often place such patients at an increased risk of nephrogenic systemic fibrosis. Quiescent-interval single-shot (QISS)-MRA is a robust non-enhanced MRA method that has shown promising results at 1.5 T and 3 T. Here, we wished to evaluate the image quality and diagnostic accuracy of QISS-MRA at 3 T in diabetic patients with CLI compared with CE-MRA with calf compression, with digital subtraction angiography (DSA) serving as the standard reference.