Atherosclerosis is the most frequent cause of lower extremity peripheral artery disease and claudication. Atherosclerotic risk factors include smoking, diabetes, dyslipidemia, hypertension, sedentary lifestyle, etc. Intensive evidence-based management of atherosclerotic risk factors decreases the incidence of major adverse cardiovascular and limb events. We provide an overview of cardiovascular risk factors and their management to modify them with a focus on patients with lower extremity peripheral artery disease and claudication.