Patients with advanced peripheral arterial disease may develop critical limb ischemia with rest pain, non-healing ulcerations, and eventually may require major amputation despite currently available revascularization technologies. Stem cell therapies hold promise as novel therapeutics to promote vasculogenesis and improve tissue perfusion in these patients. This article reviews the current state of stem cell therapy for patients with peripheral arterial disease, with a focus on the cell types that have been studied, barriers to clinical development, and development of new endpoints for clinical trials.