Background Exercise training improves walking ability in patients with peripheral arterial disease (PAD), but whether exercise training improves the long-term outcome of these patients remains unknown. Methods and Results Participants were 118 PAD patients who were enrolled in a 12-week supervised exercise program. The long-term outcomes of 64 patients who completed the training were compared with the outcomes of 54 patients who did not. The primary endpoint was cardiovascular mortality, and the secondary endpoint was cardiovascular morbidity. Mean follow-up was 5.7±3.9 years. The cardiovascular death-free rate was higher in patients who completed the training program than in those who did not (p=0.022). Multivariate analysis showed independent predictors of cardiovascular death were age over 70 years, diabetes mellitus, maximum walking distance, history of coronary revascularization, and completion of training program. The cardiovascular event-free rate was also higher in patients who completed the training program (p=0.048). Conclusions Supervised exercise training improved cardiovascular mortality and morbidity in patients with PAD, which suggests that exercise training should be considered as a secondary prevention strategy for these patients.