In recent years percutaneous therapy has gradually been adopted as an alternative to primary amputation in persons deemed unsuitable as surgical candidates, and has established itself as a primary mode of treatment. There has been an explosion in endovascular technology and a revolution in revascularization patterns for limb salvage. Open surgery is now frequently reserved for failure of endovascular attempts or pathology unsuitable for endovascular revascularization. This article aims to educate the practicing general surgeon about the usefulness and appropriate application of different therapeutic endovascular options as applied to limb salvage.