This study aimed to compare the association of statin treatment with incident major adverse cardiovascular event (MACE) between patients undergoing revascularization for symptomatic lower extremity artery disease (LEAD) and those for coronary artery disease (CAD). We enrolled 10,658 patients undergoing revascularization for either symptomatic LEAD or CAD between September 2019 and June 2021. Of them, the present study analysed the 4,861 patients (2,061 and 2,818 patients undergoing revascularization for LEAD and CAD, respectively) who did not receive a statin before revascularization. Of the 4,861 patients, 2,557 patients (408 with LEAD and 2,149 with CAD)initiated statin treatment at revascularization (the statin group), whereas the remaining 2,304 patients (1,635 with LEAD and 669 with CAD) did not (the non-statin group). The median follow-up period was 35.1 (interquartile range, 13.6–38.6) months. The primary outcome measure was the incident of major adverse cardiovascular event (MACE), defined as a composite of non-fatal myocardial infarction, stroke, and cardiovascular death. The propensity score matching extracted 378 pairs in the population with LEAD and 585 pairs in the population with CAD. The hazard ratio of statin treatment for incident MACE was 0.63 (95% confidence interval, 0.37–1.07) in the population with LEAD and 0.67 (0.35–1.25) in the population with CAD, with no significant difference between the populations (P = 0.89). The ratio in the overall population was 0.64 (0.430.97; P = 0.034). No baseline characteristics had any significant interaction effect on the association between statin treatment and incident MACE risk, and their interaction effect did not significantly differ between the population undergoing revascularization for LEAD and that for CAD (all P > 0.05). The association of statin therapy with incident MACE was not significantly different between patients undergoing revascularization for LEAD and those for CAD. Statin treatment would be as beneficial for patients requiring revascularization for LEAD as for those requiring revascularization for CAD.