Background: Chronic Aorta Iliac Occlusive Disease (CAIOD) is a significant cause of lower limb ischemia and is often found in various age group with varied etiology. Objective: To review recent results achieved treating CAIOD patients with open surgery and endovascular surgery. Methods: From January 2017 to December 2018, 39 patients , who were admitted in Tamilnadu Government Multi Super Specialty Hospital, affiliated to The Tamilnadu Dr.M.G.R Medical University. Tamilnadu, Chennai. were operated with diagnosis of aorta iliac occlusion. Demographic data, co morbidities, clinical presentation and surgical results were analyzed. Results: Thirty six men and 3 women were treated with aortic reconstruction. procedures included aortic bi femoral bypass (ABF; n=18), Ilio- Femoral Bypass ( IFB; n=3), Aorta Iliac Plasty (AIP, n=1 ). Mean age was 53.7 ? 7.3 years (range: 43-79 years) and 30 patients were smokers. Thirty patients (%) had critical limb ischemia. Six of the patients treated with ABF (%) also required additional revascularization ( femoropopliteal procedures). Perioperative mortality was two. Four patients (%) suffered transitory renal dysfunction, but only one patient (%) required hemodialysis. Median follow-up time was 17 months (range: 2-29 months) and there was just one late death, from ischemic heart disease, 7 months after the surgery on the abdominal aorta. Conclusions: Aortic reconstruction with both open and endo- vascular methods is a safe for treating patients with Aorta iliac occlusions, with low perioperative morbidity and mortality rates.