Aim To investigate the application value of monocyte (MONO) to high density lipoprotein (HDL) ratio (MHR) in the early screening of peripheral arterial disease (PAD). Methods 131 patients hospitalized in our hospital from January 1,7 to December 1,7 were retrospectively analyzed. According to the results of color Doppler ultrasonography of lower extremity arteries, the patients were divided into two groups:(1)80 patients in the disease group had obvious stenosis (＞50%) and/or occlusion of lower extremity arteries; (2)51 patients in the control group had normal lower extremity arteries. General information and laboratory findings of patients were collected. The difference of MHR was compared between two groups. The predictive values of MONO, HDL and MR for PAD were assessed.Results There were no significant differences in general condition, blood routine and biochemical indexes between the two groups (P＞0.05). MONO and MHR in the disease group were significantly higher than those in the control group, and HDL was significantly lower than that in the control group (P＜0.001). ROC curve analysis showed that the areas under the curve of MONO, HDL and MR predicting PAD were 0.1,0.657 and 0.820, respectively. The sensitivity of MHR was the highest (88.2%). Compared MHR with MONO (Z＝1.978, P＝0.048), MHR with HDL (Z＝2.963, P＝0.002), the differences were statistically significant. Conclusion MONO, HDL and MHR are correlated with PAD, while MHR is more sensitive and valuable for early prediction of PAD.