Background: Older adults with diabetes mellitus who have had the condition for a long time are more prone to develop peripheral artery disease. To encourage collateral circulation in the lower extremities, perform the Buerger Allen exercise, which involves dynamic postural exercises for both legs.

Aim: To evaluate the effect of Buerger Allen exercise on improving lower extremities perfusion among diabetic elderly patients.

Design: A quasi-experimental research design was utilized.

Setting: The current study was carried out in medical outpatient clinic and medical department of Minia University Hospital, Egypt. Subjects: A purposive sample of (120) diabetic elderly patients.

Tools: First Tool: patient assessment sheet included two parts, demographic data and medical profile. Second Tool: peripheral circulation assessment tool.

Results: the means of age were (66.2 ± 3.74 & 65.9 ± 4.59) for the study and control groups respectively, and more than half of the both groups were females. Concerning the assessment of peripheral perfusion, the study group exhibited sufficient (good) peripheral perfusion at posttest with percentages of (65%) and (61.7%) for right and left leg respectively after 8 weeks of applying the Buerger Allen exercise as compared to (43.3% & 41.7%) before, with a highly statistical significance difference (P? 0.01) was detected between the two groups. Conclusion: Implementation of Buerger Allen exercise positively enhanced the peripheral perfusion of lower extremities particularly (capillary refill time, peripheral pulses, temperature and skin color) among diabetic elderly patients.