Aim: To determine the prevalence of peripheral arterial disease (PAD) amongst HIV positive patients and HIV negative subjects and associated risk factors at Aga Khan Hospital Nairobi Design:Cross-sectional descriptive study Patients and Setting:A group of 125 HIV positive and 120 HIV negative subjects aged between 40 – 70 years were included in the study. HIV negative subjects were sampled from HIV positive patients attending the HIV outpatient clinic while HIV negative subjects were sampled from blood donor unit at theAga KhanUniversityHospital. Methodology: Two separate convenient samples were selected for the study. The first sample was a group of 125 HIV positive subjects aged between 40 -70 years attending the HIV outpatient clinic. The second sample was a group of 120 HIV negative subjects aged between 40 – 70 years selected from the blood donor unit. All subjects underwent clinical evaluation and measurement of ankle brachial index (ABI). A questionnaire was also administered to all subjects. Analysis was then performed to determine the prevalence of peripheral arterial disease and for the risk factors contributing to PAD in the two populations. Results: The prevalence of PAD in the HIV study population was 19.2% and in the HIV negative population was 7.5%. In the bivariate analysis, diabetes was the only predictor of PAD amongst the HIV negative group while in the HIV positive group, the log-viral load and low CD4 count were the only statistically significant predictors of PAD. In the multivariate analysis, factors that were significantly associated with PAD in the HIV negative group were: diabetes [OR 13 (2.5 – 76.1)] and smoking-pack-years [OR 1.09 (1.01 – 1.19)]. However in the HIV positive group, body mass index [OR 1.15(1.03 -1.29)], hypertension [OR 3.3 (1.01-10.8)] and CD4 count [OR 0.995 (0.992-0.998)] were the significant associations. Conclusion:Prevalence of PAD in the HIV population was higher than has been reported in both the general population and in the HIV negative population in this study.