Hypertension was a major risk factor for cardiovascular disorder including Peripheral Arterial Disease (PAD). Objective: To evaluate the risk of Peripheral Arterial Disease (PAD) in newly diagnosed hypertensive patients using Ankle-Brachial Index (ABI) measurements and to determine its potential role as a predictor of cardiovascular risks in this population. Methods: The study was an observational, cross-sectional study. This study was conducted in Khairpur Medical College Civil Hospital Khairpur Mirs. The duration of this study was six months, from November 2023 to April 2024This study include n= 246 newly diagnosed hypertension. Three levels of ABI had been identified through determining the ABI in both legs: low ABI (<0.9), normal ABI (0.9-1.4), and high ABI (>1.4). Student’s t-test. Pearson correlation test have been utilized when assessing the significance of the association between ABI levels and blood pressure values. Results: ABI was normal in 60% of the 246 participants, low in 20% and high in 20% of them. In comparison to those who had normal and high ABI, participants who had low ABI showed considerably higher SBP in both lower limbs (p < 0.001). Furthermore, there was additionally a significant distinction (p < 0.001) in the SBP and DBP among people who had high ABI. Participants with average ABI had higher SBP in their right upper limb than those who suffered from elevated ABI (p < 0.001). Conclusion: This study showed that in individuals who have recently identified high blood pressure, there was a significant relationship among ABI levels and arterial pressure levels.