OBJECTIVES: Peripheral arterial hypertension (PAH) is a rare progressive disease characterized by increased blood pressure in the arteries in the lungs and right side of the heart.  The objective of this study is to examine drivers of hospital utilization in patients with PAH. METHODS:   A retrospective descriptive study was conducted on a cross-section of PAH discharges in the MedAssets health system data for inpatient (N=3,080) and outpatient (N=32,133) visits from October 2013 through September 2015. Multivariable logistic regression was used to identify significant drivers of inpatient admission. RESULTS: The sample included 19,832 unique patients from 376 hospitals.  More than half of the discharges (70.2%) were female with an average age of 62.2 and average Charlson comorbidity score of 2.6.  The most common comorbid conditions were congestive heart failure (41.2%), chronic obstructive pulmonary disease (34.3%), diabetes (31.5%), renal disease (20.3%), hypertension (17.3%), and cardiac dysrhythmias (14.9%).  While nearly 75% of patients had a single hospital visit during this two year timeframe approximately 6% of the population had five or more visits.  Only 13% of patients were admitted as an inpatient, however the average length of inpatient stay was 9.1 days and the average cost of inpatient admissions was $23,145. In the inpatient population 5.4% expired during the hospital stay.  Hypertensive chronic kidney disease (OR=5.8, p<.0001), anemia (OR=5.4, p<.0001), depression (OR=3.8, p<.0001), history of smoking (OR=3.4, p<.0001), and cardiac dysrhythmias (OR=3.1, p<.0001) were the largest predictors of inpatient admission. CONCLUSIONS: Patients diagnosed with PAH have a large number of comorbidities.  Better management of the disease may lead to better patient outcomes and a reduction in hospital utilization and healthcare costs.