Peripheral artery disease (PAD) affects more than 200 million people worldwide, among whom more than two-thirds reside in low- and middle-income countries (LMIC). China, as the largest LMIC, faces a challenge from the burden of PAD as the country undergoes economic expansion. We compared the patterns of PAD between China and Western countries to determine if there are differences in risk factors, awareness or treatment of PAD. Literature searches were performed both in English databases and Chinese databases covering January 1, 1995 to March 1, 2020. Both landmark and high-quality articles were evaluated. The prevalence of PAD in high-income countries increases linearly with age, whereas PAD increases slowly until the middle-60s and exponentially thereafter in China. In contrast to Western countries, the prevalence of PAD in China is reported to be higher in women than in men. There is a higher prevalence of risk factors in China, but the rates of awareness and treatment of these risk factors are low. The lack of awareness and lower rates of treatment and control of PAD and its risk factors in China may be underlying the higher prevalence of PAD in women than in men as well as the steep increase in PAD after the middle-60s. In all countries more attention should be paid to the planning and implementation of preventative strategies and clinical services. The societal and economic effects of PAD are considerable and ongoing studies are needed to help curtail the burden of this disease. Copyright © 2021. Published by Elsevier Inc.