You wear a paddle board leash by clipping the rail-saver loop to the D-ring at the tail of your board, then fastening the padded cuff snugly around your ankle so the board stays tethered to you if you fall.
That tether is the whole point. Your board is the biggest flotation device you have, and on a windy day an untethered board blows across the water faster than you can swim after it. The leash keeps it within arm's reach every time you go in.
Where it attaches on the board
Look for the small D-ring or attachment loop at the tail, behind the standing area. Thread the leash's rail-saver strap through it and cinch it down. The rail-saver is the flat webbing section that sits against the board so the cord does not saw into the rail. Give it a firm tug to check it is secure before you launch.
Where it goes on your leg
For flatwater paddling, which is most SUP, wear the cuff around your ankle on your back leg. The Velcro cuff should be snug but not tight enough to cut off circulation. If you are doing SUP surf, many paddlers move the cuff up to just below the knee so the extra cord clears the deck when you step around.

The NIXY Hybrid Leash 10' uses a coiled cord that mostly stays on the deck instead of dragging in the water, plus a rail-saver and a padded cuff, so it is a simple, comfortable everyday choice for flatwater paddlers.
One safety note that matters: on rivers or moving water, a fixed ankle leash can snag on rocks or branches and hold you under. In current, use a quick-release waist leash instead, not an ankle leash. For lakes, bays, and calm coastal water, the ankle setup above is the standard.
Frequently asked questions
Which ankle do you wear a paddle board leash on? Wear it on your back foot's ankle so the cord trails behind you and stays clear of your stance. Snug the Velcro cuff so it will not slip off, but keep it comfortable.
Do you attach a leash to the front or back of the board? The back. The D-ring or attachment loop sits at the tail behind the standing area, so the board trails behind you when you fall rather than swinging toward you.
Should you wear a leash on flat, calm water? Yes. Even on calm water, wind and boat wake can push a loose board away quickly. A leash keeps your flotation with you. The exception is fast-moving rivers, where a quick-release waist leash is safer than an ankle leash.
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