Can a 20 year old get peripheral arterial disease (pad)?

Yes, rarely: There certain congenital conditions (inherited) which can cause the body's arteries to age at an extremely rapid rate. Members of such families experience extremely early heart attacks and blood vessel disease. Some of these conditions can be well treated while others are much more difficult. If you are suspicious that you have one of these, a visit to a cardiologist is recommended.

Youthful PAD: Pad occurs when there is a narrowing of the arteries. While there are many causes, the most common is a build up of calcified plaque which takes years to occur and is most commonly associated with cigarette smoking, high cholesterol and diabetes among other things. It is extremely rare for these to occur in the young.