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The aim of the study was to investigate the feasibility of low-tube-voltage computed tomography (CT) in combination with 3-dimensional adaptive iterative dose reduction (AIDR-3D) algorithm in lower extremity CT angiography.The CT data of the 120-kV group (n = 30) were reconstructed with filtered back projection (FBP) algorithm. The CT data of the 100-kV group (n = 30) were reconstructed with FBP as well as AIDR-3D algorithms.The 100-kV group showed significantly lower dose-length product than the 120-kV group (P < 0.05). In comparison with the 120-kV and FBP protocol, the 100-kV and FBP protocol showed significantly increased vascular density and noise (P < 0.05). However, in the 100-kV group, images reconstructed with AIDR-3D showed significantly lower noise and significantly higher signal-to-noise ratio and contrast-to-noise ratio than FBP (P < 0.05).Low-tube-voltage (100 kV) 320-row CT in combination with AIDR-3D reconstruction can significantly improve the image quality and reduce radiation dose of lower extremity CT angiography.