OBJECTIVE: To identify the association between objectively measured physical activity and walking capacity with cognitive function in patients with symptomatic peripheral artery disease. METHODS: This was an observational, cross sectional study. One hundred and thirty patients (age 67 ± 8 years) were recruited at a tertiary centre specializing in vascular disease. Cognitive function (global, memory, executive function and attention) was evaluated using the Montreal Cognitive Assessment tool. Physical activity levels (total, light, and moderate-vigorous) were obtained using an accelerometer. A 6 min and 4 m walk test were undertaken to assess walking capacity. Crude and covariate adjusted, linear regression analyses confirmed significant associations between physical activity levels and walking capacity with cognitive function. RESULTS: Positive and significant associations were observed between moderate to vigorous physical activity (p = .039) and walking capacity (p = .030) with memory after adjusting for covariates. No significant association was identified between light physical activity and usual gait speed with any cognitive function outcome. CONCLUSION: Greater memory performance was associated with greater moderate to vigorous physical activity levels and walking capacity in patients with symptomatic peripheral artery disease. Clinical interventions focused on improving moderate to vigorous physical activity levels and walking capacity may provide important therapies to potentially enhance cognitive health in patients with peripheral artery disease.