Background/Aims: Peripheral arterial disease (PAD) has been suggested as a contributing factor to the development of intradialytic muscle cramps in patients on maintenance hemodialysis. Methods: To test this hypothesis, 122 patients from two dialysis centers were studied. The presence of PAD was determined by measurement of the ankle-brachial index (ABI) in the lower extremities of patients pre- and postdialysis. The experience of intradialytic cramps was assessed using patient history and review of medical records. Results: PAD defined as a predialysis ABI ≤0.90 had an overall prevalence of 16.4% among patients studied. The prevalence of PAD was age-dependent, reaching 37.5% in patients 80–89 years old. Intradialytic muscle cramps were common, with 52.1% of patients reporting cramps within the previous two months, but there was no relationship between cramps during dialysis and PAD (p > 0.05). Conclusions: PAD was common in hemodialysis patients, but there was no association between the presence of PAD and the prevalence of intradialytic muscle cramps.