Background Spinal cord stimulation (SCS) has been applied for the treatment of ischemia pain of limbs which can ameliorate chronical ischemia rest pain, ulcer and gangrene through dilation of the peripheral vessels, the improvement of microcirculation and inhibition of pain transduction. However, the precise mechanisms of SCS are still unclear now. Objective This article reviews the mechanisms of vasodilation and analgesia effects of SCS for the treatment of ischemia pain of limbs. Content Some possible mechanisms have been elucidated, including the sympathetic modification, the reverse activation of the sensory nerve, the modulation of descending system and the release of analgesic substance and the indications, curative effect, complications in clinical application. Trend Patients with chronic limb ischemia pain not amenable to open surgical or endovascular intervention have been identified as candidates for SCS therapy.