Congestive heart failure (CHF) is a prevalent disease with many comorbidities and is associated with high health care expenditures. Peripheral arterial disease (PAD) is a known comorbidity of CHF and is associated with worse morbidity and mortality. CHF and PAD share risk factors, pathophysiology, treatment strategies, and prognostic features. We review the impact of PAD on patients with CHF using several studies to support PAD's influence on outcomes in CHF. Based on the evidence and current guidelines, patients with heart failure who are smokers, and those who have known coronary artery disease and/or diabetes should be screened for PAD.