Females with peripheral arterial disease (PAD) treated with endovascular interventions have increased limb-based procedural complications compared to males. Little is known regarding long-term bleeding risk in these patients who often require long-term antiplatelet or anticoagulation therapy. We hypothesize that females have a higher incidence of bleeding events compared to males in the year following endovascular intervention for PAD. Adults (≥65 years) who underwent endovascular revascularization for PAD between 2008-2015 in Medicare claims data were identified. Patients were allocated by prescribed post-procedural antithrombotic therapy including 1) antiplatelet therapy, 2) anticoagulation therapy, 3) dual antiplatelet and anticoagulation therapy, and 4) no prescription antithrombotic therapy. Bleeding events were classified as gastrointestinal, intracranial, hematoma, airway, or other. Crude and covariate-standardized 30-, 90- and 365 days cumulative incidence of bleeding events, overall and by sex, were estimated using Aalen-Johansen estimators accounting for death as a competing risk. Sex differences were identified using Gray’s test. Of 31,593 eligible patients, 54% were females. Females were older (77.9 vs 75.5 years) and tended to use antiplatelet therapy more often at 30-, 90- and 365 days post-intervention. Clopidogrel was the most prescribed antiplatelet, and 32% of patients continued its use at 365 days. Anticoagulants were prescribed to 26% of patients at the time of the procedure, and only 8.8% continued anticoagulation at 365 days. Thirty-one percent of patients were diagnosed with a bleeding event within 1-year after intervention. Cumulative incidence of any bleeding event during the post-intervention period was higher in females compared to males with a risk difference of 3% between sex cohorts (p<0.01). Specifically, females had a higher incidence of GI bleed and hematoma (p<0.01), but a lower incidence of airway-related bleeding at each time point compared to males (p<0.01). Sex disparities in bleeding complications following endovascular intervention for PAD persist long-term. Females are more likely to be readmitted with a bleeding complication up to one-year post-procedure. Antithrombotic therapy disproportionately increases the risk of bleeding in females. Further research is necessary to understand the mechanisms responsible for abnormal coagulopathy in females post endovascular therapy. Females experienced significantly more long-term bleeding complications in this retrospective Medicare claims cohort study of 31,593 patients undergoing endovascular intervention for infrainguinal peripheral arterial disease. The authors suggest that increased awareness and careful consideration of antithrombotic utilization, specifically in female patients, is necessary to reduce sex-based differences in postoperative outcomes.