To explore the clinical efficacy of endovascular treatment for lower extremity arteriosclerosis obliterans.A total of 34 patients (43 limbs) with lower extremity arteriosclerosis obliterans undergoing endovascular treatment from July 2010 to July 2012 were analyzed. The cohort had Fontaine stage II b (n = 16), Fontaine stage III (n = 10) and Fontaine stage III (n = 8). Among them, the lesions were of TASC IIA (n = 4), TASC IIB (n = 8), TASC IIC (n = 9) and TASC IID (n = 13). All patients underwent percutaneous transluminal angioplasty (PTA) plus stents after computed tomographic angiography (CTA) or digital subtraction angiography (DSA). And 9 patients underwent femoral endarterectomy associated with endovascular treatment.The success rate of this technique was 100%. One iliac artery ruptured during endovascular surgery. One patient suffered intraoperatively from arterial perforation. One patient was amputated one week later. One patient had in-stent thrombosis at Week 3 post-treatment. One patient was amputated at Week 4 after endovascular treatment. Thirty patients (38 limbs) were followed up for 13.3 months. During the follow-up, 3, 4 and 4 limbs became occluded at Month 6, 12 and 24 post-treatment respectively.Endovascular treatment has an excellent early patency rate. Special issues should be properly handled during endovascular treatment.