The incidence and prevalence of peripheral artery disease among hemodialysis patients both increase with the improvement of diagnostic methods. Therapies of noncritical ischemia status include risk factor reduction, exercise, podiatry care and medication; therapies of critical ischemia status include endovascular treatment, surgical revascularization and amputation. The prognosis is still poor nowadays regardless of contemporary therapeutic modalities. Further investigations, including pathogenesis identification, early diagnostic and therapeutic algorithms establishment, intervention timing confirmation, and multidisciplinary team approach, are warranted to improve the outcomes.