Background/Aims: Obesity is a major risk factor for Peripheral Arterial Disease (PAD) and is linked to various comorbidities that can impact clinical outcomes. This study aimed to explore the associations between BMI and clinical factors in PAD patients. Methods: This retrospective cross-sectional study included all patients with PAD diagnosis treated at a public tertiary hospital in Sydney between June 2022 and June 2023. Data were collected by reviewing Electronic Medical Records (EMR). Descriptive analysis and correlation were used, and hierarchical regression was conducted in three steps: first step included demographic variables, second step added PAD-related clinical variables, and final model incorporated all comorbidities. Results: Of 427 participants with PAD, 233 (54.6%) had BMI recorded and were included. The mean age of the participants was 73.1 years (95% CI: 71.5,74.7), with the majority being male (69.5%). Chronic limb-threatening ischemia was present in 55.5% of participants, while 28.8% had intermittent claudication. The average weight of participants was 78.4 kg (95% CI: 75.8,80.8), resulting in BMI of 27.6 kg/m² (95% CI: 26.8,28.4). Step 1 revealed that demographic variable (age and gender) explained 3.8% BMI variation (R2=0.038; F=5.613, p=0.004). When PAD associated clinical variable (PAD surgery and PAD stage) was added, the model further strengthened by 8.2% (R2=0.12; F=6.083, p<0.001) and had a negative association. Addition of comorbidities, including OSA(p<0.001), COPD(p=0.005), osteoporosis(p=0.031) and hypertension (p=0.040), increased the model significantly (R2=0.315; F=10.0858, p<0.001) collectively explaining 31.5% BMI variation. Conclusion: Demographic variables, PAD-related clinical factors, and comorbidities collectively explained 31.5% of BMI variance in PAD patients. Comorbidities such as OSA, COPD, osteoporosis, and hypertension, were significant contributors, emphasising their role in managing obesity and underweight in PAD patients.