Objective To investigate the prevalence of peripheral arterial disease (PAD) and correlative risk factors among natural population in China. Methods Ankle brachial index ( ABI) was measured by trained doctors and related data were collected in residents from Beijing, Shanghai, Changsha, Guangdong, Neimenggu, and Xinjiang selected through cluster multistage and random sampling method. PAD was defined as an ABI ≤ 0. 9 in either leg. Results The prevalence of PAD among 21 152 eligible participants was 3. 08% , the standardized prevalence was 3. 04%. The prevalence in males and females was 2. 52% and 3. 66% and the standardized prevalence was 1. 84% and 4. 31% respectively, the prevalence rate was significantly lower in males than that in females (P < 0. 01). The prevalence in both males and females increased significantly in proportion to aging ( P < 0. 01 ) . The prevalence in Han Chinese was significantly higher than that in non-Han Chinese ( P < 0. 01). Logistic regression analysis showed that older age, female gender, Han Chinese, waist circumference, smoking, lipid disorder, diabetes mellitus, coronary artery disease and a history of ischemic stroke were associated with the increased prevalence of PAD. Incidence of known PAD was 1.38% in this cohort. Conclusions Older age, female gender, Han Chinese, waist circumference, smoking, lipid disorder, diabetes mellitus, coronary artery disease and a history of ischemic stroke were associated with the increased prevalence of PAD in natural Chinese population.