Peripheral arterial disease (PAD) is a common vascular condition that affects the lower extremities, and its prevalence is increasing worldwide. We studied 100 patients over a period of 9 months to understand the role of duplex ultrasound in peripheral arterial disease and assess the spectrum of vascular disease in western Gujarat population. Duplex ultrasound is a non-invasive imaging modality that plays a crucial role in the diagnosis, evaluation, and management of PAD. This technique combines two types of ultrasound, B-mode and Doppler, to visualize the arterial anatomy and assess blood ow velocities. Duplex ultrasound provides accurate information about the presence and severity of stenosis or occlusion, as well as the hemodynamic signicance of the disease. It can classify PAD based on various parameters, including the ankle-brachial index (ABI) and pulse wave velocity (PWV). Duplex ultrasound is also useful in monitoring disease progression and treatment response. The technique has several advantages over other imaging modalities, including its non-invasive nature, lower cost, portability, and ability to provide real-time imaging during interventions. However, interpreting duplex ultrasound results requires expertise in vascular anatomy and hemodynamics. Overall, duplex ultrasound is a versatile and valuable tool in the diagnosis and management of PAD