BACKGROUND: The multicompound herbal drug Padma 28 is based on a formula from Tibetan Medicine and has been used in Switzerland for over 30 years in the symptomatic treatment of circulatory disorders including intermittent claudication. OBJECTIVE: What is the current evidence regarding the clinical efficacy and safety of this drug in patients with peripheral arterial occlusive disease(PAOD)? MATERIALS AND METHODS: Electronic databases were searched (each from inception to fall 2005) as well as the reference lists of the relevant articles. RESULTS: 14 articles were found including 6 published studies, 1 un-published study, 6 double publications and 1 meta-analysis. Six studies analyzed maximum walking distance, 5 of these showed a significant increase. The pooled data of the meta-analysis confirmed a significant and clinically relevant increase of the maximum walking distance by more than 100 m in about 1 out of 5 patients. Serious adverse events were not related to verum, non-serious adverse events were equally frequent as under placebo. CONCLUSIONS: The evidence available shows that the multi-target therapy with Padma 28 provides statistically significant and clinically relevant relief from PAOD-related symptoms, i.e. an increased walking distance.