Peripheral arterial disease (PAD) is an atherosclerotic disease of the limbs. Creatine chemical exchange saturation transfer (CrCEST) MRI can be used to visualize creatine metabolism as it occurs in the muscles of the calf. We have successfully applied CrCEST in 13 healthy subjects and 7 PAD patients in order to characterize the effect of ischemia on skeletal muscle energetics. Creatine concentration decay was assessed by CrCEST over a period of 8 minutes after plantarflexion exercise. Time course CEST asymmetry plots show features of PAD decays that help reveal mechanisms of metabolic dysfunction.