Peripheral artery disease (PAD) is a chronic disorder that results from atherosclerosis of the major arteries, commonly in the legs. As blood flow to the limbs is reduced, patients experience a progressive decline in functional ability and may have pain with movement or at rest. Up to half of all patients with PAD experience symptoms of depression, though depression is underdiagnosed and undertreated in this population. Patients with depression experience a faster decline in walking ability and poorer functional outcomes from revascularization. Comorbid depression also increases the risk of limb amputation and death in this group; therefore, diagnosing and treating depression is a critical target for improving outcomes in PAD. It is imperative to improve rates of depression screening in PAD populations and to develop an integrated behavioral health pathway that includes medical treatment (e.g., selective serotonin reuptake inhibitors), therapy (e.g., cognitive behavioral therapy), and PAD treatment goals (e.g., exercise, revascularization) to maximize patient outcomes and improve health behaviors.