Our aim was to investigate how dyslipidemia was diagnosed and treated in patients with peripheral artery disease (PAD) in a university vascular clinic. Design. Our analysis included all 1 843 PAD patients (median age 71 years, interquartile range 63–79, M/W 975/868) who attended the clinic in 2002–2003 either for diagnostic angiography or for revascularization. The charts of patients tested for dyslipidemia were reviewed closer Serum lipids were measured in only 214 PAD patients (11.6%). Of them 37.9% smoked, 59.8% had antihypertensive medication, 35.0% diabetes, and 30.8% a history of coronary heart disease. Mean serum cholesterol concentration was 4.5 mmol/l (SD 1.3), LDL-cholesterol 2.54 (0.48), HDL-cholesterol 1.25 (0.48), and triglycerides 1.62 (0.84). Only 40 patients (19.7%) were using statins, this was increased to 72 (33.6%) after clinic visit. Consequently, 50.0% and 53.2% met the current total cholesterol (<4.5 mmol/l) and LDL-cholesterol (<2.5 mmol/l) goals, respectively. Dyslipidemia was highly under-diagnosed among PAD patients. Serum lipids were measured only in a minority and among them serum lipid values and the use of hypolipidemic drugs were not optimal according to guidelines.