Introduction: Over the past 2 decades, the use of peripheral endovascular intervention (PVI) has surpassed surgical revascularization as the primary treatment modality for patients with symptomatic peripheral artery disease (PAD) refractory to non-invasive interventions. Hypothesis: To examine the patterns of care and associated outcomes in patients with PAD undergoing ambulatory lower extremity PVI (LE-PVI) in the United States (US). Methods: Records for patients with PAD who underwent LE-PVI between 01/01/2016 and 12/31/2017 were identified using appropriate CPT codes in the National Ambulatory Surgery Sample, the largest ambulatory surgery database in the US. Patient demographics, comorbidities, socioeconomic status, hospital characteristics, periprocedural mortality and complications were computed using Stata 15.0. Results: Total 266,574 (weighted) LE-PVI encounters were identified during the study period. The cohort had a mean age of 68.9 years and 40.5% were female (Table 1). Most common comorbidities were hypertension (54.3%), ischemic heart disease (IHD) (36.3%) and diabetes (24.6%). Periprocedural mortality (PM) was 0.02%, mean charges per encounter were $56,500, and 97.6% patients were discharged home. Complication rate was low (3.3%) including distal emboli (1.8%), dissection (0.4%), periprocedural bleeding (0.3%) and acute kidney injury (0.3%). On multivariable analysis, age [OR(CI), p = 1.02 (1.003 to 1.04), 0.02], Midwest region [OR(CI), p = 1.9 (1.2 to 3.2), 0.01], Southern region [OR(CI), p = 2.2 (1.3 to 3.7), 0.002], IHD [OR(CI), p = 1.6 (1.2 to 2.2), 0.002], arrhythmia [OR(CI), p = 2.4 (1.7 to 3.4), <0.001], valvular disease [OR(CI), p = 1.5 (1.01 to 2.3), 0.045], and coagulopathy [OR(CI), p = 2.6 (1.1 to 5.9), 0.03] were associated with higher odds of PM. Conclusion: Our nationally representative study demonstrates the overall safety of ambulatory LE-PVI in a real-world setting with low periprocedural complications and mortality.