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Purpose To evaluate the effect of chronic kidney disease (CKD) on all-cause mortality, major adverse limb event (MALE), MALE + POD (post-procedure death), and amputation after endovascular treatment of superficial femoral (SFA) or popliteal arterial atherosclerotic disease. Materials and Methods A retrospective review from January 2002 to October 2011 was performed of four hundred forty patients who underwent endovascular treatment of symptomatic SFA or popliteal atherosclerotic disease for claudication (N=251) or critical limb ischemia (CLI) (N=267). CKD stage was divided based on the Kidney Dialysis Outcomes Quality Initiative (KDOQI) classification. The outcomes and factors associated with amputation, MALE, and MALE + POD were determined. Results Patients with a diagnosis of diabetes [HR=2.2; 95% CI (1.3–3.6), P=0.002] and a run off score of 0 or 1 [HR=2.0; 95% CI (1.2–3.4), P=0.01] relative to run off score of 3 were at increased risk of amputation. A patient with a baseline GFR of less than 45 had a 17% increase in amputation for every 5 point decrease less than 45 [95% CI (1.09–1.26), P<0.001]. An increase of 10 years in age, [HR=1.9, 95% CI (1.5–2.3), P<0.001], a TASC class of C/D relative to A/B [HR=1.6, 95% CI (1.1–2.2), P=0.01], and CLI [HR=2.4, 95% CI (0.5–0.9), P<0.001] were associated with increased mortality. A female gender was associated with a decreased risk of mortality [HR=0.7, 95% CI (0.5–0.9), P=0.01)]. Conclusion Worsening CKD is associated with higher amputation rates, all-cause mortality, and MALE + POD in patients undergoing endovascular treatment of SFA or popliteal disease.