Objective-The purpose of this study was to determine the association between 25-hydroxyvitamin D (25(OH)D) levels and the prevalence of peripheral arterial disease (PAD) 4 Basic science research indicates that low vitamin D levels may be linked with cardiovascular risk. Vascular smooth muscle cells possess the 1-␣ hydroxylase enzyme that locally activates circulating vitamin D. 5 In animal models, active vitamin D is an inhibitor of the renin-angiotensin system 6 and myocardial cell hypertrophy. 7 Cellular experiments show that active vitamin D and its analogs exhibit anticoagulant activity. 8 Conflicting data are available on the association between low 25(OH)D levels and cardiovascular disease in the general population. 9 -11 Among adults, 25-hydroxyvitamin D (25(OH)D) levels Ն30 ng/mL are considered optimal. 12 These levels are associated with reduced fracture rates and have been postulated to be associated with better health outcomes. 12 The goal of the current study was to evaluate the association between serum 25(OH)D levels and the prevalence of PAD in the general population. To accomplish this goal, we analyzed data from a nationally representative sample of the United States adult population aged Ն40 years in NHANES 2001 to 2004. In addition, elevated serum calcium, phosphate, and intact parathyroid hormone (iPTH) levels have been associated with cardiovascular disease in the general population. 13,14 Because these serum markers are associated with vitamin D levels, we assessed the association between these serum markers and PAD in a secondary analysis.