BACKGROUND: This was a randomized clinical trial to determine whether Nordic pole walking (NPW) is more effective in improving walking distance than a standard home exercise programme (HEP) in patients with intermittent claudication. METHODS: Fifty-two patients with stable claudication were allocated randomly to a standard HEP or NPW group, and asked to complete three 30-min walks per week for 12 weeks. Claudication distance (CD) and maximum walking distance (MWD) were measured at 0 (baseline), 4, 8 and 12 weeks. Patients in the NPW group were tested with (NPW+) and without (NPW–) poles. RESULTS: For NPW+, CD increased immediately from a median (range) of 124 (71–248) m to 148 (116–426) m, and MWD from 248 (149–900) to 389 (194–1099) m (P = 0·004 and P < 0·001 respectively). By 12 weeks, CD had further increased to 199 (118–550) m and MWD had more than doubled to 538 (250–1750) m (P < 0·001 and P = 0·001). For NPW–, CD at 12 weeks had increased significantly to 151 (100–328) m and MWD to 400 (200–900) m (P < 0·001 and P = 0·006 respectively). At 12 weeks the changes in the standard HEP group were not significant, despite excellent compliance: CD from 107 (56–332) to 153 (59–321) m and MWD from 355 (92–600) to 334 (149–874) m (P = 0·030 and P = 0·260 respectively). CONCLUSION: A 12-week exercise programme using Nordic poles significantly improved walking distance in claudicants compared with a standard HEP. Registration number: ISRCTN78168304 (http://www.controlled-trials.com).Nordic poles are beneficial