Background: The study is aimed to evaluate the association between raised serum Homocysteine levels and severity of Peripheral Vascular Disease (PVD) and its role as a prognostic marker in PVD. Thereby, Vitamin K therapy can be instituted for lowering Homocysteine levels as prophylaxis against cerebral and coronary events in PVD patients. Methods: The serum homocysteine levels was measured in all patients admitted for peripheral vascular disease of upper and/or lower limb and to correlate the abovevalues with Doppler ultrasonography (USG) in the duration between 2020-2022(18 months) Results: The comparison of homocysteine levels with Doppler shows corresponding significant increase in Serum homocysteine levels only in cases of moderate PVD. Statistical analysis with binary logistic regression does show a significant association with moderate severity of PVD and serum homocysteine levels with 80% predictability. Conclusions: There was significant association of homocysteinemia only in Moderate PVD with no statistically significant correlation with mild, severe cases of peripheral arterial disease (PAD) and radiological normal cases, further large randomized trials are required to elucidate its clinical relevance in PAD as a prognostic marker of Severity.