Women with peripheral arterial disease (PAD) are not well identified in cardiology practice, are undertreated, and have different relative risks for development of PAD than men. Recognizing that PAD is considered a coronary artery disease risk equivalent emphasizes that primary care physicians and cardiologists need to be aggressive for screening and treatment of this disorder. This article reviews the prevalence and risk factors for PAD in women, sex-based differences in development of PAD, and current screening and treatment recommendations.