External iliac arteriopathy is narrowing or blockage of the external iliac artery caused by repetition and heavy exercise. The disease appears to occur most often in high-performance cyclists.
Research has shown that a cyclist´s thigh is excessively bent while riding. That puts additional stress on the wall of the external iliac artery, as does the increased heart output that results from intense exercise. Additionally, the external iliac artery is prevented from moving during exercise by its origin in the pelvis and the athlete´s taut inguinal ligament.
The disease appears to occur primarily among high-performance bicyclists who bicycle around 10,000 miles per year.

Surgery is the most common treatment for external iliac arteriopathy. Patients may have operative synthetic patch angioplasty or graft replacement of their external iliac and common femoral arteries. Replacement of the external iliac and common femoral arteries is performed for more severe and extensive forms of the disease. The inguinal ligament is released where it crosses the femoral artery.