Analysis of 22,166 atrial fibrillation catheter ablations revealed that patients with peripheral artery disease (PAD) face significantly elevated procedural risks. Among the 899 PAD patients (4.06% of cases), major bleeding increased by 62%, vascular complications by 80%, and acute kidney injury by 31% compared to those without PAD, despite similar mortality rates. This finding illuminates a critical consideration for cardiovascular procedural planning. Atrial fibrillation ablation has become increasingly common as populations age, yet risk stratification remains imperfect. The substantially higher comorbidity burden in PAD patients—including greater cardiovascular, renal, and smoking histories—likely contributes to their elevated risk profile. These results suggest clinicians should exercise heightened caution and potentially modify procedural approaches for PAD patients undergoing AF ablation. The 13% increase in hospital charges further underscores the clinical and economic implications. However, this retrospective database analysis from 2016-2020 has inherent limitations in establishing causation and may not reflect current techniques. As this remains a preprint awaiting peer review, these risk associations require validation before definitive clinical guideline changes.