ABSTRACT Background: Critical limb ischemia (CLI) is a severe degree of peripheral arterial occlusive disease (PAD) that requires rapid intervention to avoid limb loss and its associated mortality and morbidity .The mainstay of treating of a patient with critical limb ischemia is to reperfuse his limb which can be achieved by direct revascularization by surgical interference or endovascular management or indirect revascularization through other conservative measures as medical therapy, spinal cord stimulation and hyperbaric oxygen. This study aims to compare between the outcomes of endovascular intervention and conservative management of patients with critical limb ischemia. Subjects & methods: The study included 76 patients with critical limb ischemia CLI, 38 patients were treated by endovascular intervention  and the other 38 patients were conservatively. Results: Results proved that revascularization of critical limb ischemia patients by endovascular intervention was better than conservative management in terms of limb salvagability and patient survival. Conclusion: Endovascular intervention was found to be a promising and more effective procedure than conservative management in patients with critical limb ischemia and the conservative procedure should be limited to patients not feasible to revascularization.