OBJECTIVES:  This study uses data from hospitals across the United States to estimate the prevalence of peripheral artery disease (PAD) among inpatient hospitalizations and to explore the clinical and economic burden to the hospital when treating patients with advanced PAD with either revascularization or amputation. METHODS:  Data was derived from the MedAssets health system database of more than 400 hospitals across 42 states for the years 2010-2014. To be eligible for inclusion, inpatient hospitalizations required a diagnosis of PAD and a record of an intervention (revascularization or major/minor amputation). Adverse event rates, length of stay (LOS), and average reimbursement per diem were calculated by intervention for all PAD patients and a subset of patients with a primary PAD diagnosis. RESULTS: Of the over 17 million inpatient hospitalizations in the database, 616,401 (3.5%) have a diagnosis of PAD, with 95,561 (15.5%) having a record of an intervention. Of these visits, 48,072 (50.3%) had a primary diagnosis of PAD with 35,220 (73.3%) having a revascularization alone, 8,955 (18.6%) having a major/minor amputation alone and 3,897 (8.1%) having both. Rates of sepsis or other infection (5.8% vs 1.6%) and pulmonary complications (10.6% vs 5.3%) are higher for patients having a major amputation alone versus revascularization alone. Average hospital reimbursement per diem estimates were significantly lower for the major amputation cohort versus the revascularization cohort ($2,383 vs $4,399). This is driven by LOS which is almost 2X higher for major amputation versus revascularization (11.0 vs 5.9 days). CONCLUSIONS:  PAD affects a significant number of inpatient admissions with a substantial hospital burden due to complications and long lengths of stays. Hospital limb salvage programs that include revascularization procedures/algorithms may reduce this burden while providing cost savings to the hospital.