Aim: peripheral arterial disease (PAD) is an important complication of diabetes and a risk factor for increasing mortality and cardiovascular events. PAD screening is indicated for all patients with diabetic foot ulcers (DFU). The most adopted screening test is the ankle-brachial index (ABI); however, literature data demonstrated a low sensitivity of ABI probably due to media arterial calcifications. This study aimed to evaluate: 1) the accuracy of commonly used tests for PAD diagnosis in patients with DFU; 2) the accuracy of screening tests when combining more than one test. Methods: We included in the present retrospective analysis (protocol number 23273_oss) a consecutive series of outpatients attending our Diabetic Foot Unit for a DFU. We investigated the presence of PAD using the following screening tests: pulse palpation, ABI, ankle pressure, toe pressure, toe-brachial index, transcutaneous oximetry, and waveform analysis (WFA). Doppler ultrasound was used for the diagnosis of PAD (at least one stenosis >50%). The positive and negative likelihood ratios (PLR and NLR), sensitivity, specificity, and accuracy were calculated. All statistical analyses were performed using SPSS 25.1. Results: We included 97 consecutive patients with DFU referring to our Clinic between 1st January 2022 and 31st December 2022. A total of 64 (66%) patients had peripheral artery disease diagnosed with ultrasound Doppler. ABI sensitivity and specificity were 0.82 and 0.64, respectively. The corresponding figures for TBI, waveform analysis, and TcPO2 were 1,0 and 0.62, 0,83 and 1.0, and 1.0 and 0.25, respectively. To increase the performance of screening tests, we decided to combine more than one test. The most performant individual test was WFA. When using two further tests in addition to pedal pulses, the sensitivity increases up to 0.97 with TBI and WFA, with a trivial reduction of specificity. Conclusions: the combination of three tests (pedal pulses+TBI+WFA) provided a higher accuracy in predicting PAD in patients with DFU.