During lower limb exercise, blood flow through the resting upper limbs exhibits a change characterised by increased anterograde flow during systole, but also large increases in retrograde diastolic flow. One explanation for the retrograde flow is that increased sympathetic nervous system (SNS) tone and concomitant increased peripheral resistance generate a rebound during diastole. To examine whether the SNS contributes to retrograde flow patterns, we measured femoral artery blood flow during arm-crank exercise in 10 healthy men (31±4yrs) and 10 spinal cord-injured (SCI) subjects who lack sympathetic innervation in the legs (33±5yrs). Before, and every 5 minutes during 25-minutes arm-crank exercise at 50% maximal capacity, femoral artery blood flow and peak anterograde and retrograde shear rate were assessed using echo Doppler sonography. Femoral artery baseline blood flow was significantly lower in SCI compared with controls. Exercise increased femoral artery blood flow in both groups (ANOVA, P<0.05), while leg vascular conductance did not change during exercise in either group. Mean shear rate was lower in SCI than in controls (P<0.05). Peak anterograde shear rate was higher in SCI than in controls (P<0.05), while peak retrograde shear rate did not differ between groups. Arm-crank exercise induced an increase in peak anterograde and retrograde shear rate in the femoral artery in controls and SCI subjects (P<0.05). This suggests that the SNS is not obligatory to change the flow pattern in inactive regions during exercise. Local mechanisms may play a role in the arm-crank exercise-induced changes in flow pattern in the femoral artery.