Advances in the diagnosis and treatment of patients with vascular disorders have led to the emergence of a new kind of internist with special skills in vascular medicine. The growth of this field will accelerate as recent major advances in vascular biology attain clinical application. In recognition of these developments, programs for vascular medicine are in place or in development across the country. Proliferation of these programs will be facilitated by multidisciplinary collaboration among cardiologists, radiologists, vascular surgeons, and other physicians with special expertise in the wide range of vascular disorders. Internists trained in these programs fill major needs; they will advance the field of vascular medicine by forming a bridge with vascular biologists to bring research advances to clinical fruition; they will apply the latest therapeutic and diagnostic tools to give optimum care to patients suffering from vascular disease and associated medical disorders such as hyperlipidemia, hypertension, and hypercoagulopathy; and they will appropriately refer these patients for invasive interventions.