We prospectively examined whether vascularfactors are related to an increased incidence of ChronicIdiopathic Distal Symmetric Neuropathy (CI-DSN) in anon-diabetic elderly population. In 8 Italian municipalities,2,512 men and women without both diabetes and CI-DSNat baseline are examined. Potential effect of vascular fac-tors was estimated by regressing new onset CI-DSN on theoccurrence of several vascular diseases and risk factors.Multivariate relative risks of CI-DSN were estimated byCox proportional hazards models. After 3.8 (±2.4) years offollow-up, we documented 51 incident CI-DSN cases. Atunivariate analysis, age, comorbidity, waist circumference,leg length, peripheral artery disease, and coronary heartdisease proved to increase the risk of developing CI-DSN.By multivariate analyses, only age (RR=1.08; 95 % CI,1.02–1.14), leg length (RR=1.05; 95 % CI, 1.01–1.1) andperipheral artery disease (RR=2.75; 95 % CI, 1.15–6.56)proved significant predictors of CI-DSN. Separate analysesby gender show that age is an independent predictor of CI-DSN both in men and in women, while PAD predicts thedisease only in men, together with body height. Incidenceof CI-DSN is higher in individuals carrying vascular con-ditions. In men, the presence at baseline of peripheralartery disease is associated with a threefold increase in therisk of developing CI-DSN. The incidence of neuropathy innon-diabetic individuals is associated with potentiallymodifiable vascular factors.