A key unmet need in the care of patients with intermittent claudication is a mechanism to improve adherence to exercise therapy. While many well-designed studies have been conducted, there remain limitations for comparing specific regimens as well. As knowledge has been accumulated, two themes have emerged that offer suggestions for improved adherence. First, patients have several barriers to complying with in-person, supervised exercise therapy. Given that, optimization of the efficacy of home-based programs is warranted. The second theme is that some form of check-in and/or cognitive-behavioral element increases motivation and adherence. Options, including the leveraging of technology, to address these needs are discussed herein.