Peripheral arterial disease (PAD) is a prevalent, chronic, and progressive atherosclerotic disease process involving the conduit vessels of the extremities. Most patients who present with objective signs of PAD are asymptomatic. These patients are at an increased risk of dying from cardiovascular events. Lipid management is the mainstay of risk-factor modification for patients with cardiovascular disease. Some evidence suggests that hypocholesterolemic drugs may halt the progression of atherosclerotic peripheral vascular disease. More recently, treatment with 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) inhibitors have demonstrated improved function in patients with symptomatic peripheral vascular disease. This paper reviews the role of lipid therapy in patients with peripheral arterial disease with focus on functional improvement and symptomatic relief based on the available data.