Peripheral artery disease is a prevalent but underdiagnosed manifestation of atherosclerosis.There is insufficient awareness of its clinical manifestations, including intermittent claudication and critical limb ischemia, and of its risk of adverse cardiovascular and limb outcomes. In addition, our inadequate knowledge of its pathophysiology has also limited the development of effective treatments, particularly in the presence of critical limb ischemia. This review aims to highlight essential elements of the epidemiology and pathophysiology of peripheral artery disease; bring attention to the often-atypical manifestations of occlusive arterial disease of the lower extremity and to increase awareness of critical limb ischemia; briefly describe the diagnostic role of the ankle brachial index; and go over the contemporary management of peripheral arterial disease.