Objective: To investigate the correlation between ATP binding cassette transporter G1 (ABCG1) polymorphisms and lower extremity atherosclerosis disease (LEAD) in individuals aged over 60. Methods: 200 hospitalized patients with LEAD confirmed by vascular ultrasound (case group) and 66 age-matched healthy controls (control group) were enrolled. ABCG1-rs1378577, rs225374, and rs57137919 polymorphisms were analyzed via TaqMan probe assay. The correlation between ABCG1 polymorphism and LEAD in elderly individuals was analyzed. Logistic regression was used to analyze the risk factors of LEAD in elderly patients. Results: For the ABCG1-rs1378577 locus: Genotype distribution in cases was GG > GT > TT, showing statistical significance (P GG > CC, without statistical significance (P>0.05). For the ABCG1-rs57137919 locus: genotype distribution in the case group ranked GG > AG > AA, showing statistical significance (P<0.05). The AA genotype exhibited a negative correlation with disease incidence (r=-0.172, P<0.05), while Logistic regression identified that the GG genotype increases the risk of disease (OR=4.168, P<0.05). Conclusion: ABCG1-rs1378577 and rs57137919 are correlated with LEAD in the elderly, while ABCG1-rs225374 shows no significant correlation.