Purpose: Peripheral arterial disease (PAD) is associated with reduced blood flow to the limbs and carries significant morbidity and mortality. Despite its prevalence, there is currently no ideal biomarker to screen for PAD, risk stratify patients, or monitor treatment response. PAD has been shown to reduce blood flow in the ophthalmic artery and central retinal artery. Evaluating the retinal microvasculature using optical coherence tomography angiography (OCTA) can provide valuable information about early microvascular damage in PAD. Methods: This pilot study involved 20 patients with PAD and 20 controls. All participants underwent a standard eye examination. A cirrus Zeiss OCTA device was used to determine the perfusion and vessel density of the parafoveal capillary network. Results: The mean age of the participants was 65.2 years (SD = 5.11). The mean vessel density in 3 x 3 mm OCTA was significantly reduced in the PAD group compared to the control group (p = 0.013). Also, the mean perfusion density in 3 x 3 mm OCTA was significantly reduced in the PAD group compared to the control group (p = 0.013). Similarly, the mean vessel density and mean perfusion density in 6 x 6 mm OCTAs were significantly reduced in the PAD group compared to the control group (P = 0.040 and p = 0.036). However, there was no significant difference in the foveal avascular zone parameters between the PAD and the control group. Conclusion: OCTA could aid as a quick, non-invasive, and inexpensive imaging biomarker in PAD detection