Abstract
Peripheral artery disease (PAD) is rapidly emerging as a global health priority, with projections indicating a dramatic rise in prevalence, mortality, and disability by 2050. Recent forecasts project an approximately 220% increase in PAD prevalence, with more than 360 million individuals affected globally by mid-century, largely driven by metabolic diseases-particularly diabetes and obesity. A recent population-based study forecasting the global burden of PAD provides compelling evidence that metabolic disease is the dominant driver of this alarming trend. This commentary highlights the critical interplay between metabolic risk factors and PAD progression, underscores the disproportionate burden expected in low- and middle-income countries, and calls for urgent, integrated strategies targeting metabolic health. Without decisive action to reduce diabetes, obesity, and related metabolic disorders, the looming global PAD crisis will further strain healthcare systems and deepen health inequities worldwide.