Abstract Background: Open surgery alone for multi segmental lower limb arterial occlusion has high morbidity. Hybrid intervention can provide shorter hospital stay and less invasive procedures especially for high risk cases. Aim of Study: To evaluate hybrid intervention for treatment of symptomatic common femoral artery (CFA) occlusive lesions combined with proximal or distal arterial lesion. Patients and Methods: This prospective study included 53 patients with symptomatic common femoral artery occlusion combined with proximal and/or distal arterial lesions. Hybrid approach was performed for all patients; open surgery for common femoral artery lesions and endovascular interventions for other lesions. Follow up was one year. Results: No mortality was reported but there was technical failure in two cases; Primary patency was reported in 50 patients (96.2%), 48 patients (92.3%) and 36 patients (69.3%) After one month, 6 months and 12 months respectively. Limb salvage rate was observed in 50 patients (96.2%), 44 patients (84.6%) and 40 patients (76.9%) After the first month, 6 months and 12 months respectively. Secondary patency was restored in 12 patients (23.1%) after one year. Conclusions: Hybrid approach; play very important role in the treatment of symptomatic common femoral artery occlusion combined with iliac and/or infrainguinal arterial lesions with acceptable patency and limb salvage rates and allow satisfactory, minimal morbidity and durable intervention options especially in high risk patients to a great extent.