We aim to evaluate the development of peripheral occlusive artery disease (PAOD) in patients with migraine by using the National Health Insurance Research Database in Taiwan. A retrospective cohort study was conducted and individuals with diagnostic codes of migraine were enrolled in the study group after excluding those diagnosed with PAOD before the index date. Each subject with migraine was propensity-score matched to another non-migraine patient and the latter served as the control group. A total of 37,288 patients were finally enrolled in the groups. The primary outcome was set as the development of PAOD between the two groups while multiple possible risk factors, including demographic data and comorbidities, were analyzed via the Cox proportional hazards regression. There were 885 and 530 PAOD events in the study and control groups, and the study group had a significantly higher adjusted hazard ratio (1.65, 95% confidential interval: 1.48-1.84, < 0.001), and the cumulative incidence also revealed a correlation between migraine and PAOD. Other potential risk factors related to the existence of PAOD include age, hypertension, chronic kidney disease, diabetes mellitus, coronary artery disease, stroke, and asthma. For individuals without certain systemic diseases including hypertension, chronic liver disease, chronic kidney disease, coronary artery disease, stroke, asthma, or heart failure, the hazard ratio of subsequent PAOD was significantly higher in the migraine patients than that in the non-migraine individuals (all < 0.001). In conclusion, the presence of migraine is a significant risk factor for the development of subsequent PAOD.