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Background: Peripheral arterial disease (PAD) is an underdiagnosed illness often affecting the elderly population. Ankle brachial index (ABI) is a good diagnostic tool for PAD in outpatient practice, but remains underused. Materials and methods: Patients were recruited from an outpatient medical camp in rural India, and assessed for symptoms and pre-existing risk factors. Measured ABI ≤ 0.9 was considered abnormal and considered PAD. Results: Out of 100 patients recruited, PAD was diagnosed in 57 patients. Associated risk factors were like age >55 years (67%), hypertension (66%), smoking (69%) and diabetes mellitus (35%) were common. Conclusion: PAD is a very common and underdiagnosed illness in rural India. A simple tool like ABI can help diagnosis in underserved areas. Keywords: Peripheral arterial disease, Ankle brachial index, Screening