Peripheral arterial disease (PAD) is an indicator disease for generalized atherosclerosis and cardiovascular death. PAD patients often present with a significant comorbidity of other secondary atherosclerotic conditions. In primary care settings, general practitioners (GPs) hold an essential role in screening of patients at risk, who rarely present with typical symptoms, and risk factor management, followed by the initiation of adequate treatment. Screening is based on the ankle–brachial index (ABI) as a reliable marker of subclinical and clinical PAD as well as the overall atherosclerosis burden. The majority of patients respond to non-invasive therapies such as risk factor modification in terms of lipid lowering and antihypertensive measures as well as antiplatelet−/phosphodiesterase (PDE)-III-inhibitor therapy. Nevertheless, disease progression affects a quarter of all PAD cases, despite having successfully implemented all treatment options available in primary care. In these cases, surgical−/catheter-based interventions are indicated and a cooperation between vascular specialists and GPs, establishing long-term PDA-management plans, ensures the best possible outcome. Early diagnosis of PAD in primary care is of utmost importance in order to establish secondary preventative measures, reducing the overall cardiovascular risk.