RATIONALE: Knowledge about the prevalence of objectively assessed peripheral artery disease (PAD) and its clinical relevance in patients with COPD is scarce. OBJECTIVES: We aimed (1) to assess the prevalence of PAD in COPD compared to distinct control groups and (2) to study the association between PAD and functional capacity as well as health status. METHODS: The ankle-brachial index (ABI) was used to diagnose PAD (ABI≤0.9). 6-Minute-Walk-Distance (6MWD), health status (St. George's Respiratory Questionnaire [SGRQ]), COPD Assessment Test [CAT] and EuroQol-5-Dimensions [EQ-5D-3L] were assessed in patients enrolled in the German COPD and Systemic Consequences-Comorbidities Network (COSYCONET) cohort study. Control groups were derived from the Study of Health in Pomerania (SHIP). MEASUREMENTS AND MAIN RESULTS: 2,088 patients with COPD (61.1% male, mean [SD] age 65.3 [8.2] years GOLD stage I,II,III,IV: 9.4%,42.5%,37.5%,10.5%, respectively) were included. 184 patients (8.8%; GOLD stage I,II,III,IV: 5.1%,7.4%,11.1%,9.5%, respectively, versus 5.9% in patients with GOLD stage 0 in COSYCONET) had PAD. In SHIP, PAD ranged from 1.8% to 4.2%. COPD patients with PAD had a significantly shorter 6MWD (356  vs 422  m, p<0.001) and worse health status (SGRQ: 49.7 [20.1] vs 42.7 [20.0] points, p<0.001, CAT: 19.6 [7.4] vs 17.9 [7.4] points, p=0.004, EQ-5D VAS: 51.2 (19.0) vs 7.2 (19.6), p<0.001). Differences remained significant after correction for several confounders. CONCLUSIONS: In a large cohort of patients with COPD, 8.8% were diagnosed with PAD which is higher than the prevalence in non-COPD controls. PAD was associated with a clinically relevant reduction in functional capacity and health status.