Dr. Sameh Sayfo and Dr. Nicolas Shammas discuss critical limb ischemia (CLI) and the use of lasers in below-the-knee (BTK) treatment. They explain the challenges of treating infrapopliteal disease and the efficacy of laser atherectomy for calcified lesions. The ongoing multicenter study on the Auryon laser atherectomy system in CLI patients is reviewed, along with advice on building a strong CLI program.