Background: Peripheral arterial disease (PAD) is common in patients with chronic kidney disease (CKD). It is a surrogate marker of generalized atherosclerosis. In sub-Saharan Africa, PAD remains understudied in CKD. Ankle-brachial index (ABI) is a non-invasive and cost-effective tool to diagnose PAD. Objectives: Our aim was to determine the prevalence and associated risk factors for PAD in hemodialysis patients. Patients and Methods: We conducted a cross-sectional study from July 1 to December 31, 2012 in the department of Nephrology of the University Hospital Aristide le Dantec of Dakar. All consenting patients, aged above 18 years, on hemodialysis for at least 6 months were included. ABI measurements were performed using a handled pulse doppler. PAD was defined as an ABI of <0.9 or the history of surgical revascularization and/or amputation due to vascular disease. The patients were divided into two groups according to the presence or not of PAD. Standard blood tests and anthropometrical parameters were recorded. Results: A total of 53 patients with a mean age of 49.15 ± 15.18 were included. The sex ratio was 0.70. Hypertension (83.01%), low HDL-cholesterol (26.41%) and cigarette smoking (20.75%) were the main cardiovascular risk factors. Prevalence of PAD was 47.16%. Among patients with PAD, 52% had no suggestive symptoms. Lower pre-dialysis (p = 0.0384) and post-dialysis (p = 0.0447) diastolic blood pressure (BP) were significantly associated with PAD. The conventional risk factors (tobacco consumption, diabetes, alcohol consumption, dyslipidemia, hypertension, age), iPTH and CRP levels were not